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Article: Randomized trial of low-dose misoprostol and naproxen vs. nabumetone to prevent recurrent upper gastrointestinal haemorrhage in users of non-steroidal anti-inflammatory drugs

TitleRandomized trial of low-dose misoprostol and naproxen vs. nabumetone to prevent recurrent upper gastrointestinal haemorrhage in users of non-steroidal anti-inflammatory drugs
Authors
Issue Date2001
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
Citation
Alimentary Pharmacology And Therapeutics, 2001, v. 15 n. 1, p. 19-24 How to Cite?
AbstractBackground: Prophylactic misoprostol or non-steroidal anti-inflammatory drugs (NSAIDs) with low gastric toxicity (nabumetone) has been shown to reduce mucosal injury. Aim: To compare nabumetone vs. co-therapy of naproxen with low-dose misoprostol for secondary prevention of upper gastrointestinal bleeding in NSAID users. Methods: NSAID users presenting with upper gastrointestinal bleeding were enrolled if they required long-term NSAIDs. After ulcer healing, they were randomized to receive: naproxen (500-1000 mg/day) and misoprostol (200 μg b.d.), or nabumetone (1000-1500 mg/day) and placebo misoprostol for 24 weeks. The primary end-point was recurrent upper gastrointestinal bleeding. The secondary end-point was the proportion of patients suffering from major gastrointestinal events including ulcer bleeding, symptomatic ulcers and severe dyspepsia. Results: A total of 90 patients were included in the intention-to-treat analysis (misoprostol/naproxen 45, nabumetone 45). Recurrent bleeding occurred in 10 patients (22.2%) receiving misoprostol/naproxen compared with three (6.7%) receiving nabumetone (relative risk 3.33, 95% CI: 0.98-11.32, P = 0.069). The proportion of patients suffering from major gastrointestinal events at 24 weeks was 31.1% in the misoprostol/naproxen group and 28.9% in the nabumetone group. Conclusions: Misoprostol/naproxen is not superior to nabumetone for secondary prevention of upper gastrointestinal bleeding. Neither low-dose misoprostol nor nabumetone is adequate for high-risk NSAID users.
Persistent Identifierhttp://hdl.handle.net/10722/162516
ISSN
2015 Impact Factor: 6.32
2015 SCImago Journal Rankings: 2.833
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, FKLen_US
dc.contributor.authorSung, JJYen_US
dc.contributor.authorChing, JYLen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorLee, YTen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorHui, Yen_US
dc.contributor.authorChan, LYen_US
dc.contributor.authorLai, ACWen_US
dc.contributor.authorChung, SCSen_US
dc.date.accessioned2012-09-05T05:20:41Z-
dc.date.available2012-09-05T05:20:41Z-
dc.date.issued2001en_US
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2001, v. 15 n. 1, p. 19-24en_US
dc.identifier.issn0269-2813en_US
dc.identifier.urihttp://hdl.handle.net/10722/162516-
dc.description.abstractBackground: Prophylactic misoprostol or non-steroidal anti-inflammatory drugs (NSAIDs) with low gastric toxicity (nabumetone) has been shown to reduce mucosal injury. Aim: To compare nabumetone vs. co-therapy of naproxen with low-dose misoprostol for secondary prevention of upper gastrointestinal bleeding in NSAID users. Methods: NSAID users presenting with upper gastrointestinal bleeding were enrolled if they required long-term NSAIDs. After ulcer healing, they were randomized to receive: naproxen (500-1000 mg/day) and misoprostol (200 μg b.d.), or nabumetone (1000-1500 mg/day) and placebo misoprostol for 24 weeks. The primary end-point was recurrent upper gastrointestinal bleeding. The secondary end-point was the proportion of patients suffering from major gastrointestinal events including ulcer bleeding, symptomatic ulcers and severe dyspepsia. Results: A total of 90 patients were included in the intention-to-treat analysis (misoprostol/naproxen 45, nabumetone 45). Recurrent bleeding occurred in 10 patients (22.2%) receiving misoprostol/naproxen compared with three (6.7%) receiving nabumetone (relative risk 3.33, 95% CI: 0.98-11.32, P = 0.069). The proportion of patients suffering from major gastrointestinal events at 24 weeks was 31.1% in the misoprostol/naproxen group and 28.9% in the nabumetone group. Conclusions: Misoprostol/naproxen is not superior to nabumetone for secondary prevention of upper gastrointestinal bleeding. Neither low-dose misoprostol nor nabumetone is adequate for high-risk NSAID users.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APTen_US
dc.relation.ispartofAlimentary Pharmacology and Therapeuticsen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal - Adverse Effectsen_US
dc.subject.meshButanones - Therapeutic Useen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshGastrointestinal Hemorrhage - Chemically Induced - Prevention & Controlen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMisoprostol - Administration & Dosageen_US
dc.subject.meshNaproxen - Administration & Dosageen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRecurrenceen_US
dc.titleRandomized trial of low-dose misoprostol and naproxen vs. nabumetone to prevent recurrent upper gastrointestinal haemorrhage in users of non-steroidal anti-inflammatory drugsen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1046/j.1365-2036.2001.00890.xen_US
dc.identifier.pmid11136274-
dc.identifier.scopuseid_2-s2.0-0035176303en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035176303&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume15en_US
dc.identifier.issue1en_US
dc.identifier.spage19en_US
dc.identifier.epage24en_US
dc.identifier.isiWOS:000166548300003-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.scopusauthoridChing, JYL=7005086238en_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridLee, YT=35477936800en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridHui, Y=7103107510en_US
dc.identifier.scopusauthoridChan, LY=23003415000en_US
dc.identifier.scopusauthoridLai, ACW=7102226209en_US
dc.identifier.scopusauthoridChung, SCS=19642462800en_US

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