Non-Steroidal Anti-Inflammatory Ulcer Prevention More Effective With Misoprostol

Proton pump inhibitors are superior to placebo for the prevention of NSAID-induced gastric ulcers but are not superior to misoprostol, 800µg/day.

This was the conclusion of David Graham and colleagues from their double-blind multicentre, active and placebo-controlled study of 537 patients. All patients in the study were not positive for Helicobacter pylori, were long term users of NSAIDS and had a history of endoscopically documented gastric ulcer.

Dr Graham said, "When the poor compliance and potential adverse effects associated with misoprostol are considered, proton pump inhibitors and full-dose misoprostol are clinically equivalent." He is based at the department of medicine, Veterans Affairs Medical Center, Houston, Texas, United States.

Patients were randomized to receive either placebo, 200 µg of misoprostol q.i.d. or 15 or 30 mg of lansoprazole once daily for 12 weeks. Ulcers were checked for by endoscopy.

"Patients receiving lansoprazole remained free from gastric ulcer longer than those who received placebo, but for a shorter time than those who received misoprostol," said Dr Graham. …

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