Gastrointestinal Protection by Low-Dose Oral Prostaglandin E2in Rheumatic Diseases

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Abstract
In a previous study oral prostaglandin E2 (PGE2) was shown to protect against indomethacin-induced gastrointestinal bleeding in patients with rheumatic diseases. This study examined whether a lower oral dose of PGE2, without acid antisecretory effect, is protective. Its methylated analogue 15(R)15 Me PGE2, which has effect on the acid secretion given orally, was also tested. Indomethacin, 50 mg three times daily, induced an increase in gastrointestinal bleeding measured by the 51Cr technique. PGE2, 0.33 mg three times daily, taken concomitantly significantly reduced fecal blood loss. 15(R)15 Me PGE2, 40 μg three times daily, was also effective. The prostaglandins did not increase joint symptoms and had no significant side effects. It is suggested that the combination of nonsteroidal anti-inflammatory drugs with a low oral dose of E2 prostaglandins could be used clinically, especially in patients with rheumatic diseases.