title: Evaluation of small bowel injury in patients with rheumatoid arthritis by capsule endoscopy: effects of anti-rheumatoid arthritis drugs.
abstract: OBJECTIVE
  The medical treatment of rheumatoid arthritis (RA) includes nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). We evaluated the incidence of small bowel injury in RA patients who were taking anti-RA drugs with or without concomitant NSAIDs by capsule endoscopy.
  
  
  METHODS
  A total of 28 RA patients who took low-dose corticosteroids and/or DMARDs for more than 1 year were enrolled.
  
  
  RESULTS
  The incidence of red spots did not differ between the 2 groups: 14 of 16 patients (87.5%) in the NSAID group and 11 of 12 patients (91.7%) in the non-NSAID group. In contrast, the incidence of mucosal breaks was significantly higher in the NSAID group than in the non-NSAID group: mucosal breaks were detected in 13 of 16 patients (81.3%) and 4 of 12 patients (33.3%) in the NSAID and non-NSAID groups, respectively. In the NSAID group, mucosal breaks developed in users of preferential cyclooxygenase-2 inhibitors at a frequency similar to that in users of traditional NSAIDs.
  
  
  CONCLUSIONS
  Patients taking anti-RA drugs may have an increased frequency of small bowel injury regardless of NSAID use, and NSAID use may be associated with an increased incidence of severe small bowel injury.
authors.affiliation: Department of Gastroenterology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sugimori
authors.forename: Toshio
authors.initials: T
authors.lastname: Watanabe
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tabuchi
authors.forename: Natsuhiko
authors.initials: N
authors.lastname: Kameda
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Machida
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Okazaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yamagami
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Shiba
authors.forename: Kenji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tominaga
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Oshitani
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Koike
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D053704:Capsule Endoscopy / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000293:injuries / Q000473:pathology; D007421:Intestine, Small / Q000293:injuries* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents