Effect of egualen sodium hydrate on small-intestinal mucosal damage induced by low-dose aspirin: a prospective randomized clinical trial

Abstract

Low-dose aspirin, which is widely used to reduce the risk of cardio- and cerebrovascular thrombosis, often induces gastroenteropathy by increasing the permeability of the mucosa. However, therapeutic strategies for patients with low-dose aspirin-induced small intestinal injury have not been determined. We evaluated the preventative effect of egualen sodium hydrate, a gastro-protective agent that suppresses indomethacin-induced small-intestinal damage in rats, against small-intestinal mucosal damage induced by low-dose aspirin in healthy adult male volunteers. Participants were randomly allocated to receive aspirin 100 mg/kg daily (control group, n = 10) or aspirin 100 mg/kg plus egualen sodium 30 mg daily (egualen sodium group, n = 10). Small intestinal mucosal injury was evaluated by capsule endoscopy two weeks after initiation of drug administration. Fecal analyses (occult blood test, immunochemical test, transferrin measurement and calprotectin measurement) were carried out before and after treatment. Egualen sodium significantly suppressed the total number of small intestinal injuries detected by capsule endoscopy and the positive ratio for the fecal occult blood test. Daily use of 30 mg of egualen sodium showed a preventative effect on low-dose aspirin-induced small intestinal injury. Since acid suppression therapy was reported to exacerbate NSAIDs-induced enteropathy via dysbiosis, egualen sodium may be useful for patients treated with low-dose aspirin.

Capabilities of fecal calprotectin and blood biomarkers as surrogate endoscopic markers according to ulcerative colitis disease type

“…UC patients with a previously established diagnosis who underwent colonoscopy examinations were enrolled. Those who underwent a sigmoidoscopy, with a history of colorectal surgery or U acute infectious enterocolitis, or with a regular intake of aspirin and/or other nonsteroidal anti-inflammatory drugs (NSAIDs) were excluded, (20,21) as were those unable to provide a fecal sample. To reduce the differences between numbers of colonoscopy examinations for each patient, findings of up to 2 for each patient were included in the analysis.…”

Potential Strategies in the Prevention of Nonsteroidal Anti-inflammatory Drugs-Associated Adverse Effects in the Lower Gastrointestinal Tract

“…Apart from the above agents, there are several other drugs such as sulphasalazine, 42 ecabet sodium, 43 egualen sodium, 44 curcumin, 95,96 and muscovite, 45 which were reported to have a preventive effect on NSAIDs-induced small intestine injury. However, data is very limited for these agents.…”

Mucoprotective drugs can prevent and treat nonsteroidal anti-inflammatory drug-induced small bowel enteropathy: a systematic review and meta-analysis of randomized controlled trials

“…Our systematic search provided a total of 3341 duplicate-free records. After title, abstract and full-text selection, we identified 26 RCTs 9–12,25–47 for our qualitative synthesis. We included 12 articles on the prevention 9,11,12,26–29,35,38,40,42,46 and 6 articles on the treatment 31,32,39,44,45,47 of NSAID-induced SBE in the quantitative synthesis.…”

“…After title, abstract and full-text selection, we identified 26 RCTs 9–12,25–47 for our qualitative synthesis. We included 12 articles on the prevention 9,11,12,26–29,35,38,40,42,46 and 6 articles on the treatment 31,32,39,44,45,47 of NSAID-induced SBE in the quantitative synthesis. We selected one conference abstract where relevant information was reported 39 and included an additional RCT 35 as we identified the full text of a conference abstract from our comprehensive search.…”