Misoprostol effective for healing small bowel ulcers in aspirin users
Misoprostol promotes the healing of small bowel ulcers in aspirin users whose condition is complicated by small bowel bleeding, reports a recent trial.
Researchers enrolled 84 aspirin users with small bowel bleeding who were then randomly assigned to receive either 200 µg of misoprostol four times per day (n=42; mean age 73.0±8.79 years; 54.8 percent male) or placebo (n=42; mean age 70.2±11.89 years; 61.9 percent male). The trial lasted 8 weeks, during which the participants continued taking aspirin.
Capsule endoscopy showed that 28.6 percent (n=12) of patients in the misoprostol group demonstrated complete healing of small bowel ulcers with or without red spots. This was significantly higher than that in the placebo group (9.5 percent; n=4; difference in proportion, 19.0 percent; 95 percent CI, 2.8–35.3; p=0.026).
The medium number of ulcer/erosions significantly dropped from baseline in both the misoprostol (6.5 to 2; p<0.001) and placebo (7 to 4; p=0.003) groups. However, when compared with each other, misoprostol was significantly superior in producing such reductions (p=0.005).
A similar trend was observed for haemoglobin levels. Both groups showed significant improvements from baseline (misoprostol: 9.6±2.11 to 12.1±1.73 mg/dL; p<0.001; placebo: 9.5±2.28 to 11.3±1.68 mg/dL; p<0.001), though the between-group difference achieved statistical significance in favour of misoprostol (mean difference, 0.70 mg/dL; 0.05–1.36; p=0.035).
In terms of safety, gastrointestinal events were more frequently observed in the misoprostol group, though only one patient had to withdraw from the study due to diarrhoea.