Gr. Lipscomb et al., GASTROINTESTINAL TOLERABILITY OF MELOXICAM AND PIROXICAM - A DOUBLE-BLIND PLACEBO-CONTROLLED STUDY, British journal of clinical pharmacology, 46(2), 1998, pp. 133-137
Aims The aim oi the study was to compare the effects of meloxicam and
piroxicam on the gastroduodenal mucosa in healthy adults. Methods Fort
y-four healthy volunteers were given a 28 day course of either meloxic
am 15 mg, piroxicam 20 mg or placebo. Damage to the oesophageal, gastr
ic and duodenal mucosa was assessed, mucosal blood flow (MBF) measured
at endoscopy and biopsies taken for prostaglandin content and microsc
opic assessment of damage before NSAID administration and during days
1, 7 and 28 of continued intake. Results Maximal macroscopic gastric m
ucosal damage (median grade + IQR) occurred within 24 h of piroxicam a
dministration, the damage score increasing from 0 to 2.5 (0-3) (P=0.02
) at day 1 before falling to 2.0 (0-2) at day 7 and 0 (0-1) at day 28
with resolution of damage observed in six out of the seven subjects wh
o sustained acute injury. No significant macroscopic gastric damage oc
curred in either of the two other groups although some minor damage wa
s observed in seven subjects taking placebo and five taking meloxicam.
There was a trend towards piroxicam causing more acute gastric damage
than meloxicam (P=0.06). Baseline antral, body and duodenal MBF were
similar in all three groups. No significant changes occurred in any of
the groups on any of the visits. There were also no changes in gastri
c mucosal prostaglandin content in any group. Conclusions These observ
ations suggest that meloxicam causes little acute damage to the upper
gastrointestinal tract and piroxicam causes some acute gastric injury
but such damage resolves in most subjects by 28 days.