Resistance to medical therapy of gastric ulcers in rheumatic disease patients taking aspirin. A double-blind study with cimetidine and follow-up.

Little is known about healing or recurrence of aspirin-induced gastric ulcers if aspirin intake is continued. A double-blind controlled study compared cimetidine plus antacids as needed (prn) with placebo plus prn antacids in healing aspirin-associated gastric ulcers during continued salicylate ingestion in 18 rheumatic disease patients over a 2-month period. Healing occurred in 44% of the placebo and 56% of the cimetidine-treated patients (P greater than 0.

Healing of aspirin-associated peptic ulcer disease despite continued salicylate ingestion.

Patients who have rheumatic disease and who are undergoing long-term aspirin therapy have a high incidence of peptic ulcer disease. Whether it is possible to heal long-term aspirin-related peptic ulcer disease if aspirin intake is continued is unknown. Nine patients with rheumatic disease who were receiving long-term aspirin therapy and who had 15 endoscopically verified gastric and/or duodenal ulcers were studied.

Effect of anti-inflammatory drug administration in patients with rheumatoid arthritis. An endoscopic assessment.

A prospective endoscopic study was carried out in 65 patients with rheumatoid arthritis to assess the prevalence of gastroduodenal lesions on aspirin alone or aspirin plus another anti-inflammatory drug (n = 26). All patients were taking greater than or equal to 8 tablets aspirin/day for greater than or equal to 3 months. Drug therapy consisted of regular, buffered or enteric-coated aspirin +/- one other non-steroidal anti-inflammatory drug or less than or equal to 10 mg prednisone/day.

Comparison of the effects of regular and enteric-coated aspirin on gastroduodenal mucosa of man.

To determine whether the topical or systemic effects of aspirin are of greater importance in the production of gastroduodenal mucosal damage, the effects of regular and enteric-coated aspirin were compared in 9 healthy volunteers in a 2-week crossover endoscopic study. All subjects developed multiple gastric erosions while taking regular aspirin; 2 subjects developed one gastric erosion each while taking enteric-coated aspirin. 5 subjects developed duodenal erosions while taking regular aspirin, whereas none developed an erosion while taking enteric-coated aspirin.

The prevalence of duodenal lesions in patients with rheumatic diseases on chronic aspirin therapy.

Peroral endoscopy was performed in 56 patients with rheumatic disease who had been taking 8 or more aspirin tablets daily for more than 3 months yet who had no major gastrointestinal symptoms or history of peptic ulcer disease. Duodenal mucosal lesions were observed in 16 patients; 15 (27%) had erythema, 7 (13%) had erosions, and 2 (4%) had ulcers. The prevalence of duodenal lesions was the same in patients taking regular, buffered, or enteric-coated aspirin preparations.