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World J Gastroenterol. Aug 21, 2006; 12(31): 5017-5020
Published online Aug 21, 2006. doi: 10.3748/wjg.v12.i31.5017
Effects of chronic therapy with non-steroideal antinflammatory drugs on gastric permeability of sucrose: A study on 71 patients with rheumatoid arthritis
Marta Maino, Nicola Mantovani, Roberta Merli, Giulia Martina Cavestro, Gioacchino Leandro, Lucas Giovanni Cavallaro, Vincenzo Corrente, Veronica Iori, Alberto Pilotto, Angelo Franzè, Francesco Di Mario
Marta Maino, Roberta Merli, Giulia Martina Cavestro, Lucas Giovanni Cavallaro, Veronica Iori, Francesco Di Mario, Chair of Gastroenterology, Department of Clinical Science, University of Parma, Italy
Nicola Mantovani, Gastroenterological Unit, Azienda Ospedaliera “C.Poma”, Mantova, Italy
Gioacchino Leandro, IRCCS Castellana Grotte (BA), Italy
Vincenzo Corrente, Angelo Franzè, Gastroenterological Unit, Azienda Ospedaliera, Parma, Italy
Alberto Pilotto, IRCCS San Giovanni Rotondo (FG), Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Francesco Di Mario, Chair of Gastroenterology, Department of Clinical Science, University of Parma, Via Gramsci 14, Parma 43100,Italy. francesco.dimario@unipr.it
Telephone: +39-521-702772 Fax: +39-521-701582
Received: July 20, 2005
Revised: October 20, 2005
Accepted: October 26, 2005
Published online: August 21, 2006
Abstract

AIM: To evaluate the gastric permeability after both acute and chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) and to assess the clinical usefulness of sucrose test in detecting and following NSAIDs- induced gastric damage mainly in asymptomatic patients and the efficacy of a single pantoprazole dose in chronic users.

METHODS: Seventy-one consecutive patients on chronic therapy with NSAIDs were enrolled in the study and divided into groups A and B (group A receiving 40 mg pantoprazole daily, group B only receiving NSAIDs). Sucrose test was performed at baseline and after 2, 4 and 12 wk, respectively. The symptoms in the upper gastrointestinal tract were recorded.

RESULTS: The patients treated with pantoprazole had sucrose excretion under the limit during the entire follow-up period. The patients without gastroprotection had sucrose excretion above the limit after 2 wk, with an increasing trend in the following weeks (P = 0.000). A number of patients in this group revealed a significantly altered gastric permeability although they were asymptomatic during the follow-up period.

CONCLUSION: Sucrose test can be proposed as a valid tool for the clinical evaluation of NSAIDs- induced gastric damage in both acute and chronic therapy. This tecnique helps to identify patients with clinically silent gastric damages. Pantoprazole (40 mg daily) is effective and well tolerated in chronic NSAID users.

Keywords: Non-steroidal anti inflammatory drugs; Gastric mucosal permeability; Gastrointestinal toxicity; Sucrose test; Pantoprazole