Peptic Ulcer during Treatment of Rheumatoid Arthritis with Cortisone Derivatives

Gastroscopic evaluation of anti-inflammatory agents

“…'-8 Evidence exists suggesting that non-steroidal anti-inflammatory drugs, particularly aspirin, can cause acute gastric erosions and microbleeding, [9][10][11][12] but the results obtained in clinical trials and epidemiological studies designed to prove the existence of such a relation have not been conclusive. [13][14][15] In clinical trials with patients suffering from rheumatoid arthritis (RA) and treated with various anti-inflammatory drugs the incidence of peptic ulcer has ranged from 4.6o016 to 310%.17 An incidence of 31% would appear to favour the hypothesis that patients with arthritis are particularly prone to develop peptic ulcer,17 18 but this is controversial.…”

Back Diffusion of Hydrogen Ions across Gastric Mucosa of Patients with Gastric Ulcer and Rheumatoid Arthritis

“…There seems little doubt that patients with rheumatoid arthritis requiring therapy with steroids and aspirin have a higher incidence of gastric ulcer (Kern, et al, 1957;Krammerer et al, 1958;Gedda and Moritz, 1959;Bowen et al, 1960;Taylor et al, 1968). While corticosteroids increase gastric acid secretion in dogs they do not alter ionic permeability (Cooke et al, 1966;Cooke, 1967;Chung, et al 1970).…”

“…This may be even higher in those patients treated with drugs such as aspirin, corticosteroids, and indomethacin (Kern et al, 1957;Krammerer et al, 1958;Gedda and Moritz, 1959;Taylor et al, 1968). In this paper we compare the mucosal permeability of patients with severe rheumatoid arthritis taking aspirin together with corticosteroids or indomethacin with that of patients with gastric ulcer and normal controls.…”

Gastroscopic evaluation of anti-inflammatory agents.

“…Gastric injury is a major and undesirable side effect of most anti-inflammatory agents, be they corticosteroids or nonsteroidal anti-inflammatory drugs.1'2These drugs are generally thought to be capable of aggravating existing gastric disease and in some instances of actually causing peptic ulceration. '-8 Evidence exists suggesting that non-steroidal anti-inflammatory drugs, particularly aspirin, can cause acute gastric erosions and microbleeding, 9-12 but the results obtained in clinical trials and epidemiological studies designed to prove the existence of such a relation have not been conclusive.13-15 In clinical trials with patients suffering from rheumatoid arthritis (RA) and treated with various anti-inflammatory drugs the incidence of peptic ulcer has ranged from 4.6o016 to 310%.17 An incidence of 31% would appear to favour the hypothesis that patients with arthritis are particularly prone to develop peptic ulcer,17 18 but this is controversial.…”