Ulcer Drug Aids Arthritis Patients, Researchers Find : Health: Study says misoprostol can help prevent gastrointestinal problems caused by painkillers. But some doctors worry about side effects.
An existing ulcer drug can help prevent millions of people with arthritis from developing bleeding ulcers caused by over-the-counter and prescription painkillers, according to a study.
Chronic rheumatoid arthritis sufferers who take daily doses of non-steroidal anti-inflammatory drugs, or NSAIDs, can ward off gastrointestinal side effects by also using misoprostol, researchers said.
An estimated 25% of older arthritis patients who regularly take NSAIDs develop ulcers, said the Searle pharmaceutical company, which manufactures misoprostol and partially funded the study in the Annals of Internal Medicine.
“The elderly, especially those with heart disease, just can’t tolerate the stress of serious gastrointestinal complications,” said Dr. David Graham, chief of the Baylor College of Medicine’s gastroenterology department and an author of the study.
The study, released Aug. 14, found that about 40% of 4,404 men and women who took misoprostol over a six-month period experienced fewer serious stomach and intestinal problems compared with the subjects who received a placebo.
NSAIDs, commonly found in non-prescription drugs such as Advil, Nuprin, Motrin or Aleve, inhibit the hormone-like substance called prostaglandin which triggers the fever, pain and inflammation that characterize arthritis.
Lack of naturally occurring prostaglandin can disrupt and damage protective stomach and intestinal linings, causing bleeding ulcers and tears to the delicate membrane area.
Misoprostol, discovered in 1972 by Chicago-based Searle, artificially replaces the necessary prostaglandins protecting the stomach lining.
Also known by the brand name Cytotec, misoprostol can cause uterine contractions in pregnant women. It made headlines last year because of its proposed use in a two-step abortion method with the French abortion pill, RU-486.
Other common misoprostol side effects include diarrhea and abdominal pain, although researchers said the symptoms are rarely severe.
Dr. Arthur Grayzel, a medical adviser for the Arthritis Foundation, accepted the study’s findings as valid but expressed reservations about the drug’s side effects.
Of 30 million arthritis sufferers in the United States, 2.2 million have rheumatoid arthritis, a more severe form of the disease.
“By and large, those patients are not happy about the very predictable side effects of misoprostol,” he said.
Dr. Fred Silverstein, another study author, agreed with critics who said that NSAIDs are, generally, safe.
“There is no cause for 25 million people who take them to stop from taking them,” Silverstein said. “But for the 1% who do suffer from arthritis and take NSAIDs everyday, this could save lives.”
