Nonsteroidal antiinflammatory drugs for cancer pain: Comparison between misoprostol and ranitidine in prevention of upper gastrointestinal damage

Maurizio Valentini, Renato Cannizzaro, Mauro Poletti, Roberto Bortolussi, Augusto Fracasso, Vinicio Testa, Michele Sozzi, Mara Fornasarig, Francesco Bortoluzzi, Irene Grazloli

Research output: Contribution to journalArticle

Abstract

Purpose: The prophylactic strategy of nonsteroidal antiinflammatory drug (NSAID)-induced upper gastrointestinal (UGI) damage has largely been studied in arthritic patients, but not in cancer patients. The efficacy of misoprostol and ranitidine in the prevention of gastroduodenal damage in patients taking diclofenac for their cancer pain has been compared in this study. Patients and Methods: Patients who needed high-dose (200 to 300 mg/d) diclofenac for cancer pain and without mucosal lesions at baseline gastroduodenal endoscopy were randomized to receive misoprostol (200 μg twice daily; M group) or ranitidine (150 mg twice daily; R group). UGI endoscopy was repeated after 4 weeks. Results: Twenty-three patients treated with misoprostol and 26 treated with ranitidine concluded the study. The M group showed a significantly (P <.02) lower incidence of gastroduodenal lesions (two patients; 8.7%) than the R group (10 patients; 38.5%). Gastric ulcers occurred in one (4%) misoprostol-treated patient and in six (23%) ranitidine-treated patients. Six of seven patients with ulcers were asymptomatic. Seventy-one percent and 86% of ulcers occurred in patients older than 60 years and in those who received greater than 3.1 mg/kg at diclofenac, respectively. Conclusion: Misoprostol was significantly mare effective than ranitidine in the prevention of gastroduodenal lesions in cancer patients receiving diclofenac.

Original languageEnglish
Pages (from-to)2637-2642
Number of pages6
JournalJournal of Clinical Oncology
Volume13
Issue number10
Publication statusPublished - Oct 1995

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Valentini, M., Cannizzaro, R., Poletti, M., Bortolussi, R., Fracasso, A., Testa, V., Sozzi, M., Fornasarig, M., Bortoluzzi, F., & Grazloli, I. (1995). Nonsteroidal antiinflammatory drugs for cancer pain: Comparison between misoprostol and ranitidine in prevention of upper gastrointestinal damage. Journal of Clinical Oncology, 13(10), 2637-2642.