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Volume 1, Issue 1, Pages 51-56 (January 2003)


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Sucralfate therapy in NSAID bleeding gastropathy

Juan–R. Malagelada*, Arturo Rodríguez de la Serna, Hans Gert Dammann§, Miquel Pons, Carlos Armas, Miquel Sala#, Xavier Tena**, Enrique Celdrán‡‡, Antoni Mesa‡‡

Abstract 

Background & Aims: A randomized, double-blind, placebo-controlled, multicenter study was conducted to assess the efficacy of 2 g sucralfate suspension in treating gastric mucosal lesions caused by long-term treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). Methods: Only patients given NSAIDs continuously for at least 2 months with positive fecal occult blood (FOB) and endoscopically confirmed mild to moderate mucosal lesions (Lanza scale, grades 2–4) were included. After 1-week run-in phase, patients were stratified into 2 groups according to gastropathy-related symptoms during the preceding 7 days (symptomatic vs. asymptomatic) and randomized to 2 g (10 mL) of sucralfate suspension or placebo twice a day over a 6-week period. NSAIDs were given according to each patient's dosage schedule and always after meals. Results: Twenty-five patients received sucralfate and 25 received placebo. At the end of the study, 68% (17/25) of patients given sucralfate had no lesions (Lanza grade 0) on endoscopy compared with 35% (8/23) in controls (P = 0.042). The Lanza grades in patients given sucralfate were significantly improved compared with the placebo patients (P = 0.022). Conclusions: In this target population selected according to positive FOB test and endoscopic evidence of mucosal injury, chronic administration of sucralfate significantly decreased NSAID-induced gastric erosions.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2003;1:51-56

* Department of Gastroenterology, Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona

 Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

§ Wissenschaftliches Institut, Hamburg, Germany

 Department of Rheumatology, Hospital Municipal de Badalona, Badalona

 Department of Rheumatology, Hospital Clínico Universitario “Lozano Blesa,” Zaragoza

# Department of Internal Medicine, Hospital de Figueres, Figueres

** Department of Rheumatology, “Germans Trias i Pujol,” Badalona

‡‡ Department of Clinical Research, Merck Farma y Química, S.A., Mollet del Vallés, Barcelona, Spain

 Address requests for reprints to: Juan R. Malagelada, M.D., Servicio de Aparato Digestivo, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. e-mail: malagela@hg.vhebron.es.

PII: S1542-3565(03)70010-X

doi:10.1053/jcgh.2003.50008


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