A Double-Blind, Randomized Trial of Misoprostol for Healing of Small Bowel Bleeding Ulcers in Patients on Continuous Aspirin

Misoprostol for small bowel ulcers in patients with obscure bleeding taking aspirin and non-steroidal anti-inflammatory drugs (MASTERS): a randomised, double-blind, placebo-controlled, phase 3 trial

“…As a result of effective acidinhibiting drugs, the incidence of upper gastrointestinal bleeding has decreased.1-3,6 By contrast, diagnosis of ulcers and erosions of the small bowel among individuals taking aspirin and NSAIDs has increased; these patients have few treatment options because prostaglandin production (rather than excess acid) is the primary driver of ulcer pathogenesis in the alkaline environment of the small bowel. [3][4][5][6][7][8][9][10][11]14,15 Since aspirin and NSAIDs are known to cause ulcers by suppressing mucosal prostaglandin synthesis,3-11 we chose to include patients taking these drugs in our study. These factors highlight the importance of identifying a drug that can be used to heal small bowel ulcers in patients who take aspirin and NSAIDs.…”