Low-dose misoprostol for the prevention of low-dose aspirin-induced gastroduodenal injury

Introduction: The harmful effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the gastric mucosa and the prophylactic effects of misoprostol are both dose-dependent. Aim: To investigate whether a low-dose of misoprostol is sufficient to prev ent gastric mucosal injury caused by low-dose aspirin. Methods: We conducted a double-blind placebo controlled parallel group endo scopic study in 32 evaluable volunteers. The main outcome measure was erosi ve injury (ulcers and superficial erosions) in the gastric mucosa over 28 d ays. Results: Most subjects developed erosions on aspirin 300 mg daily. This was significantly reduced by misoprostol 100 mu g daily. (Odds ratio 0.18, 95% CI: 0.07-0.48). There were no drug-related or gastrointestinal adverse eve nts in subjects receiving misoprostol. Conclusion: Misoprostol 100 mu g daily can prevent low-dose aspirin induced gastric mucosal injury without causing identifiable adverse effects.