Sucralfate therapy in NSAID bleeding gastropathy.
OBJECTIVE
A randomized, double-blind, placebo-controlled, multicenter study was conducted to assess the efficacy of 2 g sucralfate suspension in treating gastric mucosal lesions caused by long-term treatment with nonsteroidal anti-inflammatory drugs (NSAIDs).


METHODS
Only patients given NSAIDs continuously for at least 2 months with positive fecal occult blood (FOB) and endoscopically confirmed mild to moderate mucosal lesions (Lanza scale, grades 2-4) were included. After 1-week run-in phase, patients were stratified into 2 groups according to gastropathy-related symptoms during the preceding 7 days (symptomatic vs. asymptomatic) and randomized to 2 g (10 mL) of sucralfate suspension or placebo twice a day over a 6-week period. NSAIDs were given according to each patient's dosage schedule and always after meals.


RESULTS
Twenty-five patients received sucralfate and 25 received placebo. At the end of the study, 68% (17/25) of patients given sucralfate had no lesions (Lanza grade 0) on endoscopy compared with 35% (8/23) in controls (P = 0.042). The Lanza grades in patients given sucralfate were significantly improved compared with the placebo patients (P = 0.022).


CONCLUSIONS
In this target population selected according to positive FOB test and endoscopic evidence of mucosal injury, chronic administration of sucralfate significantly decreased NSAID-induced gastric erosions.
Malagelada
Juan-R
JR
Department of Gastroenterology, Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain. malagela@hg.vhebron.es
Rodríguez de la Serna
Arturo
A
Dammann
Hans Gert
HG
Pons
Miquel
M
Armas
Carlos
C
Sala
Miquel
M
Tena
Xavier
X
Celdrán
Enrique
E
Mesa
Antoni
A
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology*; D006801:Humans; D008297:Male; D009780:Occult Blood; D013392:Sucralfate / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D013392:Sucralfate