Gastrointestinal Protection by Low-Dose Oral Prostaglandin E₂ in Rheumatic Diseases

Abstract

In a previous study oral prostaglandin E₂ (PGE₂) was shown to protect against indomethacin-induced gastrointestinal bleeding in patients with rheumatic diseases. This study examined whether a lower oral dose of PGE₂, without acid antisecretory effect, is protective. Its methylated analogue 15(R)15 Me PGE₂, which has effect on the acid secretion given orally, was also tested. Indomethacin, 50 mg three times daily, induced an increase in gastrointestinal bleeding measured by the ⁵¹Cr technique. PGE₂, 0.33 mg three times daily, taken concomitantly significantly reduced fecal blood loss. 15(R)15 Me PGE₂, 40 μg three times daily, was also effective. The prostaglandins did not increase joint symptoms and had no significant side effects. It is suggested that the combination of nonsteroidal anti-inflammatory drugs with a low oral dose of E₂ prostaglandins could be used clinically, especially in patients with rheumatic diseases.

Key-words:

• Gastrointestinal blood loss
• indomethacin
• mucosal protection
• prostaglandin E₂
• rheumatic diseases