Quality of life in chronic NSAID users: a comparison of the effect of omeprazole and misoprostol.
OBJECTIVE
To compare the impact on quality of life (QoL) of omeprazole and misoprostol during healing, and omeprazole, misoprostol, and placebo during maintenance treatment in chronic NSAID users with NSAID-associated gastroduodenal lesions.


METHODS
Validated baseline and follow-up QoL questionnaires were completed by 610 patients (healing: after 4/8 weeks; maintenance: after 6 months).


RESULTS
Patients with arthritis being treated with NSAIDs have a poor QoL. Rheumatoid arthritis causes more joint problems and physical mobility limitations than osteoarthritis. Chronic NSAID use causes heartburn and dyspepsia. QoL improved on both treatments (about equally on two general QOL scales), but omeprazole relieved gastrointestinal symptoms more than misoprostol, particularly reflux, abdominal pain and indigestion symptoms. During maintenance, both treatments maintained QoL, but misoprostol induced diarrhoea.


CONCLUSIONS
QoL in arthritis patients on chronic NSAID treatment is destroyed. Omeprazole is superior to misoprostol for relief and prevention of NSAID-associated gastrointestinal symptoms allowing continued NSAID treatment without compromising the patients' QoL.
Yeomans
N
N
Department of Medicine, The University of Melbourne, Western Hospital, Footscray, Australia. n.yeomans@unimelb.edu.au
Wilson
I
I
Långström
G
G
Hawkey
C
C
Naesdal
J
J
Walan
A
A
Wiklund
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage*; D009664:Norway; D009853:Omeprazole / Q000008:administration & dosage*; D011336:Probability; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D013315:Stress, Psychological
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016595:Misoprostol; D009853:Omeprazole