title: Effect of one-month treatment with nonsteroidal antiinflammatory drugs (NSAIDs) on gastric pH of rheumatoid arthritis patients.
abstract: The use of NSAIDs is strongly associated with peptic ulceration. The inhibition of prostaglandin synthesis with the consequent increase of gastric acidity is considered a possible mechanism. Therefore we decided to assess the effect of one-month treatment with NSAIDs on the circadian gastric pH of rheumatoid arthritis (RA) patients. We studied 11 consecutive patients (one man and 10 women, median age 55, range 26-72 years) with confirmed RA. None was H. pylori positive. A 24-hr gastric pH recording was performed both in basal conditions and after one-month treatment with either indomethacin 150 mg/day (eight cases) or ketoprofen 300 mg/day (three cases). Only the 10 female patients were eligible for final analysis, and six matched healthy subjects not taking NSAIDs were used as control group. The number of 24-hr pH readings for various pH thresholds was calculated for both populations. The highest acid levels (pH < 3.0) did not differ between the two pH profiles of the control group (7440 vs 7391, P = NS), while they predominated after the one-month NSAID treatment (10,339 vs 11,440, P < 0.001) in RA patients. These findings show that there is an increased gastric acidity after one-month of treatment with NSAIDs in female patients with RA of recent onset. This may sustain the rationale of using antisecretory agents to prevent gastroduodenal ulcerations in these patients.
authors.affiliation: Dipartimento di Medicina Interna, Cattedra di Gastroenterologia and Reumatologia, Università di Genova, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Savarino
authors.forename: G S
authors.initials: GS
authors.lastname: Mela
authors.forename: P
authors.initials: P
authors.lastname: Zentilin
authors.forename: M A
authors.initials: MA
authors.lastname: Cimmino
authors.forename: M
authors.initials: M
authors.lastname: Parisi
authors.forename: M R
authors.initials: MR
authors.lastname: Mele
authors.forename: M
authors.initials: M
authors.lastname: Pivari
authors.forename: G
authors.initials: G
authors.lastname: Bisso
authors.forename: G
authors.initials: G
authors.lastname: Celle
mesh_terms: D000284:Administration, Oral; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000378:metabolism; D016022:Case-Control Studies; D002940:Circadian Rhythm; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007213:Indomethacin / Q000627:therapeutic use*; D007660:Ketoprofen / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D010437:Peptic Ulcer / Q000517:prevention & control; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007660:Ketoprofen; D007213:Indomethacin