, Volume 4, Issue 1, pp 91–100 | Cite as

An overview of the key role of misoprostol in the prophylaxis of NSAID-associated ulcers and their complications

  • G. C. Fenn
IVth International Meeting on Side-Effects of Anti-Inflammatory Drugs 7–9 August 1995, Sheffield, UK


In 22 controlled endoscopic studies misoprostol has consistently been shown to prevent NSAID-associated gastric and duodenal ulcers. The clinical relevance of such studies has now been proven by the MUCOSA study. This study in 8843 arthritic patients has shown that misoprostol significantly reduces serious NSAID-induced upper GI complications by about half, compared with placebo.

No other therapeutic agent has been shown to reduce serious complications of NSAIDs. In the majority of endoscopic studies H2-receptor blockers and omeprazole prevent duodenal but not gastric ulcers caused by NSAIDs.

Since the serious GI complications caused by NSAIDs arise from the stomach and duodenum in equal proportions, and since we cannot predict the site of occurrence, it is essential that any prophylactic agent should prevent ulcers at both sites. Misoprostol is the only agent consistently shown to do this, and allied with data showing that it reduces GI complications it can play a key role in modifying the natural history of this iatrogenic disease.


misoprostol NSAIDs prophylaxis ulcers 


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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • G. C. Fenn
    • 1
  1. 1.SearleHigh WycombeUK

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