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Gastric mucosal adaptation to etodolac and naproxen.
- Source :
-
Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 1995 Aug; Vol. 9 (4), pp. 379-85. - Publication Year :
- 1995
-
Abstract
- Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) frequently cause damage to the gastroduodenal mucosa, principally by suppressing mucosal prostaglandin synthesis. However, such acute mucosal injury usually resolves, despite continued NSAID administration, by a process known as adaptation. Newer NSAIDs, such as etodolac, have been developed to minimize effects on prostaglandin synthesis.<br />Aim: To determine whether etodolac causes less acute damage than naproxen, and whether the damage produced resolves with continued NSAID administration.<br />Methods: Twenty-four healthy volunteers were given a 28-day course of either etodolac 300 mg b.d. or naproxen 500 mg b.d. Gastroduodenal damage was assessed using a modified Lanza scoring system and mucosal blood flow with laser doppler flowmetry at endoscopy before NSAID administration and during days 1, 7 and 28 of continued intake.<br />Results: Maximum gastric damage (median grade and interquartile range, IQR) occurred during the first 24 h of administration, being greater with naproxen (2.0, IQR 1.0-3.0) than etodolac (1.0, IQR 1.0-1.5; P = 0.03). Such damage was associated with a fall in antral blood flow in the naproxen group (mean +/- S.E.M.) from 54.5 +/- 3.4 to 43.8 +/- 3.4 arbitrary units (P = 0.07) and a slight increase in mucosal blood flow in the etodolac group from 43.5 +/- 2.24 to 49.5 +/- 3.6 arbitrary units. With continued intake this damage resolved in all subjects taking etodolac and in eight of 14 subjects on naproxen. Resolution in the naproxen group was associated with a return to normal of antral blood flow.<br />Conclusions: These observations suggest that etodolac causes less mucosal damage than naproxen and that adaptation occurs to both.
Details
- Language :
- English
- ISSN :
- 0269-2813
- Volume :
- 9
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Alimentary pharmacology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 8527613
- Full Text :
- https://doi.org/10.1111/j.1365-2036.1995.tb00395.x