| Abstrakt: |
Arthritis is a major source of disability forthe American population. It results in significantmorbidity for the millions of patients affected andcosts billions of dollars yearly for diagnosis andmanagement. Nonsteroidal antiinflammatory drugs (NSAIDs)are the principal therapy for the majority of arthritispatients. It has been estimated that more than 15million people with arthritis take these drugs daily. This use is predicted to increase greatly notonly as a result of an aging population, with theconsequent increase in the prevalence of arthritis, butalso because NSAIDs may prove to have a role indecreasing colonic neoplasia and in reducing thelikelihood of conditions such as Alzheimer's disease. Itis therefore increasingly important to understand thenature of the side effects associated with these agents as well as ways of decreasing or preventingtheir occurrence. NSAIDs inhibit the enzymescyclooxygenase-1 and cyclooxygenase-2. This reduces thesynthesis of prostaglandins and therefore decreasesjoint inflammation, but it may also lead to thedevelopment of gastric and duodenal ulcers. For thisreason, exogenous prostaglandins have been studied fortheir potential role in preventing NSAID-associated ulcers and ulcer complications. This paperreviews the development of the prostagland inE1 analog misoprostol, the theory behind itsuse as a mucosal protective agent, and the results ofstudies in animals as well as in normal volunteers and patientswith arthritis. Ultimately, a study was performed toevaluate whether misoprostol reduces the incidence ofserious ulcer complications in patients taking NSAIDs. It is an interesting story, which promises tobe of increasing importance as NSAID use expands to newindications while concern remains about their associatedcomplications, especially those related to the gastrointestinal tract. [ABSTRACT FROM AUTHOR] |
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