EXPERIENCE WITH MISOPROSTOL THERAPY FOR NSAID GASTROPATHY IN CHILDREN

Objective-To determine the effect of misoprostol, misoprostol, prostag landin E(1) analogue, on the gastrointestinal tract (GIT) symptoms ass ociated with anti-inflammatory drug (NSAID) administration and on the haemoglobin value, in children. Methods-Retrospective chart review of children attending the paediatric rheumatology clinic at a tertiary re ferral hospital over a three year period, who were receiving NSAIDs an d were prescribed misoprostol for treatment of GIT symptoms or anaemia . Results-Twenty five children (mean age 12.0 (SD 2.8) (range 7-17) ye ars were prescribed misoprostol (mean dose 308.4 (76.5) mu g/m(2)/day; 9.8 (2.5) mu g/kg/day) while NSAID therapy was continued. Of the 22 ( 88%) patients with GIT complaints, 18 (82%) had complete resolution of symptoms and two (9%) had some improvement. Four patients (18%) had a recurrence of symptoms resolution while still receiving misoprostol. Misoprostol therapy was associated with a statistically significant in crease in haemoglobin concentration (mean value before misoprostol 115 (18) g/l; after misoprostol 126 (15) g/l (p=0.02)). The only adverse effect reported was self Limited diarrhoea in one child. Conclusion-Mi soprostol appeared to be effective in the treatment of GIT symptoms in children receiving NSAIDs and to result in significant increase in th e haemoglobin concentration. Further prospective studies are needed to evaluate the role of misoprostol therapy for NSAID associated GIT com plaints in the paediatric population.