A COMPARATIVE ENDOSCOPIC EVALUATION OF THE DAMAGING EFFECTS OF NON-STEROIDAL ANTI-INFLAMMATORY AGENTS ON THE GASTRIC AND DUODENAL MUCOSA

  • 1 January 1981
    • journal article
    • research article
    • Vol. 75  (1) , 17-21
Abstract
Twenty-five normal [human] volunteers were randomized into 5 equal parallel groups: Group I received ibuprofen (2400 mg/day), group II received tolmetin (2000 mg/day), group III received indomethacin (150 mg/day), group IV received naproxen (750 mg/day) and group V received placebo (4 tablets daily). All drugs were given on a q.i.d. [4 times a day] basis except naproxen which was given b.i.d. [twice a day]. The doses selected represented the manufacturer''s highest recommended dosage for the treatment of arthritic disorders. A single-blind technique was used in which the investigators were unaware of which drug each volunteer was taking. Upper gastrointestinal endoscopy and photography were carried out before and after 7 days of administration of each medication. Gastric and duodenal mucosal injury was graded on a 0-4+ scale. Three of the 4 drugs studied produced essentially equal gastric and duodenal mucosal injury, with tolmetin producing the most damage, followed by naproxen and indomethacin. Ibuprofen produced gastric mucosal injury equivalent to that seen with naproxen and indomethacin, but no duodenal mucosal injury was seen with this drug. Extremely poor correlation was found between subjective symptomatology and endoscopic findings.