Low-dose misoprostol for the prevention of low-dose aspirin-induced gastroduodenal injury.
BACKGROUND
The harmful effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the gastric mucosa and the prophylactic effects of misoprostol are both dose-dependent.


OBJECTIVE
To investigate whether a low-dose of misoprostol is sufficient to prevent gastric mucosal injury caused by low-dose aspirin.


METHODS
We conducted a double-blind placebo controlled parallel group endoscopic study in 32 evaluable volunteers. The main outcome measure was erosive injury (ulcers and superficial erosions) in the gastric mucosa over 28 days.


RESULTS
Most subjects developed erosions on aspirin 300 mg daily. This was significantly reduced by misoprostol 100 microg daily. (Odds ratio 0.18, 95% CI: 0.07-0.48). There were no drug-related or gastrointestinal adverse events in subjects receiving misoprostol.


CONCLUSIONS
Misoprostol 100 microg daily can prevent low-dose aspirin induced gastric mucosal injury without causing identifiable adverse effects.
Donnelly
M T
MT
Division of Gastroenterology, University Hospital, Nottingham; Searle, High Wycombe, UK.
Goddard
A F
AF
Filipowicz
B
B
Morant
S V
SV
Shield
M J
MJ
Hawkey
C J
CJ
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D004381:Duodenal Ulcer / Q000139:chemically induced / Q000517:prevention & control*; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D013276:Stomach Ulcer / Q000139:chemically induced / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D016595:Misoprostol; D001241:Aspirin