HELICOBACTER-PYLORI INFECTION, ABO BLOOD-GROUP, AND EFFECT OF MISOPROSTOL ON GASTRODUODENAL MUCOSA IN NSAID-TREATED PATIENTS WITH RHEUMATOID-ARTHRITIS

Our aim was to investigate the effect of misoprostol on NSAID-induced gastroduodenal mucosal damage in patients with rheumatoid arthritis. T he study included 40 patients, and it was designed as a double-blind, placebo-controlled trial Misoprostol significantly reduced the gastrod uodenal mucosal lesions found at endoscopy (P < 0.05) and prevented th e development of ulcers. The cumulative incidence of ulcers at four we eks was 5% in the placebo group and 0% in the misoprostol group. The b asal and pentagastrin-stimulated acid output as evaluated after 23 day s of treatment with misoprostol was not significantly affected. Forty- one percent of the patients had signs of current Helicobacter pylori i nfection, 33% had positive serology only, and 26% had no evidence of i nfection. Most of the patients with current infection belonged to bloo d group 0 (P < 0.05). Misoprostol treatment did not affect the occurre nce of Helicobacter pylori or the rheumatic disease activity. It is co ncluded that the protective actions of misoprostol on the gastroduoden al mucosa of NSAID-treated patients are largely mediated by mechanisms other than inhibition of acid secretion. The relationship among activ e Helicobacter pylori infection, blood group 0, and peptic ulcer may b e helpful to identify a subpopulation of patients taking NSAIDs at ris k of developing peptic ulcers.