title: Geranylgeranylacetone protects against small-intestinal injuries induced by diclofenac in patients with rheumatic diseases: a prospective randomized study.
abstract: BACKGROUND
  We aimed to explore the effect of geranylgeranylacetone on small-intestinal mucosal injuries induced by diclofenac sodium in patients with rheumatic diseases.
  
  
  METHODS
  The patients were randomly divided into two groups in our prospective study. The patients in the geranylgeranylacetone group received diclofenac sodium plus geranylgeranylacetone, and those in the control group received only diclofenac sodium for 12 weeks. We examined small-intestinal mucosal injuries using capsule endoscopy before and after treatment.
  
  
  RESULTS
  There were no significant differences between geranylgeranylacetone (n = 21, male: 42.9%; age: 31.0 ± 9.0 year) and control (n = 19, male: 68.4%; age: 31.0 ± 11.0 year) groups in terms of the numbers of patients with petechiae/red spots, denuded areas and mucosal breaks at baseline capsule endoscopy. After treatment, the numbers of patients with denuded areas (χ(2) = 0.000, P = 1.000) and mucosal breaks (χ(2) = 1.750, P = 0.186) did not increase in the geranylgeranylacetone group. However, the numbers of patients with petechiae/red spots (χ(2) = 5.216, P = 0.022), denuded areas (χ(2) = 8.686, P = 0.003) and mucosal breaks (χ(2) = 7.795, P = 0.005) increased after treatment in the control groups. Geranylgeranylacetone improved both the Lewis score (Z = -2.459, P = 0.017) and degree (χ(2) = 5.414, P = 0.020) on capsule endoscopy 12 weeks later.
  
  
  CONCLUSIONS
  In patients with rheumatic diseases, geranylgeranylacetone is effective for protecting against small-intestinal mucosal injuries induced by diclofenac sodium.
authors: Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. Electronic address: xionglishou@263.net.
authors: Lishou
authors: L
authors: Xiong
authors: Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Xinxin
authors: X
authors: Huang
authors: Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Li
authors: L
authors: Li
authors: Division of Rheumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Xiuyan
authors: X
authors: Yang
authors: Division of Rheumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Liuqin
authors: L
authors: Liang
authors: Division of Rheumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Zhongping
authors: Z
authors: Zhan
authors: Division of Rheumatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Yujin
authors: Y
authors: Ye
authors: Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors: Minhu
authors: M
authors: Chen
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D053704:Capsule Endoscopy; D004008:Diclofenac / Q000009:adverse effects* / Q000627:therapeutic use; D004224:Diterpenes / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D007413:Intestinal Mucosa / Q000187:drug effects; D007421:Intestine, Small / Q000187:drug effects* / Q000473:pathology; D008297:Male; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D004224:Diterpenes; D004008:Diclofenac; C031049:geranylgeranylacetone
keywords: Capsule endoscopy; Geranylgeranylacetone; Intestinal injury; NSAIDs