Double-blind, placebo-controlled endoscopic comparison of the mucosal protective effects of misoprostol versus cimetidine on tolmetin-induced mucosal injury to the stomach and duodenum

Lanza, Frank L.; Aspinall, Richard L.; Swabb, Edward A.; Davis, Robert E.; Rack, M. F.; Rubin, Abbe

doi:10.1016/0016-5085(88)90482-9

Cited by 132 publications

(45 citation statements)

References 22 publications

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“…In endoscopic studies, misoprostol significantly prevented damage to the gastroduodenal mucosa induced b y aspirin (70)(71)(72), naproxen (73), tolmetin (32,74), ibuprofen (76) and ethanol (76). In these studies, the mucosal protective effects of misoprostol could not be explained on the sole basis of a reduction in gastric secretion.…”

Section: Mucosal Protectionmentioning

confidence: 58%

“…Misoprostol was significantly and profoundly more potent than cimetidine, administered at an effective gastric antisecretory dose, in protecting the gastric mucosa from injury induced by tolmetin (32) and ethanol (76). These studies suggest that the inhibition of gastric acid Secretion in humans is not a significant contributor to the gastric mucosal protective effects of misoprostol, as cimetidine, at a dose which gives maximum inhibition of acid secretion, was only marginally protective (32,71). Furthermore, misoprostol was significantly more potent than sucralfate in preventing aspirin-induced injury to the gastric mucosa (77).…”

Section: Mucosal Protectionmentioning

confidence: 63%

“…A third study directly compared the efficacy of misoprostol with cimetidine and placebo in preventing tolmetin-induced gastroduodenal damage in 90 healthy volunteers over a 1-week-period (32). T h e gastric and duodenal endoscopic results are shown in Fig.…”

Section: Prevention Of Nsaid-induced Ulceration and Damagementioning

confidence: 99%

“…Misoprostol was evaluated for its potential mucosal protective properties in healthy human subjects using randomized, double-blind, placebo-controlled studies (32). Dose-related increases in the secretion of gastric mucus (64) and duodenal bicarbonate (65) have been demonstrated in man.…”

Section: Mucosal Protectionmentioning

confidence: 99%

“…It has been proposed (29) that because systemic inhibition of PG synthesis may be the pivotal event in NSAID-induced ulceration, this could explain why PG replacement is effective in preventing NSAID-induced gastric ulcers (30,31) whereas treatment with H, receptor blockers (32)(33)(34)(35) or sucralfate (36) has minimal or no effect (29).…”

Section: Introductionmentioning

confidence: 99%

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Misoprostol—a Logical Therapeutic Approach to Gastroduodenal Mucosal Injury Induced by Non-Steroidal Anti-Inflammatory Drugs?

Fenn¹,

Robinson²

1991

J Clin Pharm Ther

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SUMMARYMisoprostol is a synthetic analogue of naturally occurring prostaglandin El.T h e basis of the damaging actions of non-steroidal anti-inflammatory drugs (NSAIDs) on the gastrointestinal (GI) tract is believed to be a consequence of two events: a direct damaging action on mucosal integrity and depletion of endogenous mucosal prostaglandins (PGs). Due to the latter effect, and because current evidence indicates that PGs play an important role in maintaining the integrity of the G I tract, misoprostol has been developed as a logical therapy to prevent and heal gastric and duodenal damage caused b y NSAIDs. T h e purpose of this review is to consider the need for such a therapy, to describe its pharmaceutical development, to review its pharmacology and to review its efficacy compared with other available agents.

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