Geranylgeranylacetone protects against diclofenac-induced gastric and small intestinal mucosal injuries in healthy subjects: a prospective randomized placebo-controlled double-blind cross-over study.

Abstract

BACKGROUND AND AIMS:

Little information is available regarding the prevention and treatment of small intestinal mucosal injuries caused by non-steroidal anti-inflammatory drugs (NSAIDs). We planned a pilot study to investigate the protective effects of geranylgeranylacetone (GGA) against NSAID-induced small intestinal injuries using video capsule endoscopy (VCE).

SUBJECTS AND METHODS:

Ten healthy male volunteers took oral GGA 300 mg/day (regimen A) or placebo (regimen B) in addition to diclofenac 75 mg/day + rabeprazole 20 mg/day for 7 days. We conducted a cross-over trial of regimens A and B with a 2-week washout period. All subjects underwent VCE before and after each administration period, and were evaluated for NSAID-induced gastric and small intestinal mucosal lesions.

RESULTS:

The number of mucosal lesions (erosions, ulcers and a red spot with possible bleeding) detected in both stomach and small bowel changed between prior to and immediately after administration period, with significantly fewer lesions for regimen A after administration period (mean +/- SD A:B = 2.6 +/- 3.2:9.5 +/- 8.5; p = 0.027).

CONCLUSIONS:

Combination therapy with GGA and rabeprazole reduced the incidence of gastroenteropathy induced by 1-week administration of diclofenac. Our findings suggest this therapy as a candidate for protecting patients on long-term NSAID therapy.

• Authors: Yasumasa Niwa, Masanao Nakamura, Ryoji Miyahara, Naoki Ohmiya, Osamu Watanabe, Takafumi Ando, Hiroki Kawashima, Akihiro Itoh, Yoshiki Hirooka, Hidemi Goto
• Journal: Digestion (Digestion) Vol. 80 Issue 4 Pg. 260-6 ( 2009) ISSN: 1421-9867 [Electronic] Switzerland
• PMID: 19844108 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: 2009 S. Karger AG, Basel.

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Inflammatory Agents, Non-Steroidal
• Anti-Ulcer Agents
• Diterpenes
• Diclofenac
• Rabeprazole
• geranylgeranylacetone

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles (therapeutic use)
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Anti-Ulcer Agents (therapeutic use)
• Capsule Endoscopy
• Cross-Over Studies
• Diclofenac (adverse effects)
• Diterpenes (therapeutic use)
• Double-Blind Method
• Humans
• Male
• Peptic Ulcer (chemically induced, diagnosis, prevention & control)
• Prospective Studies
• Rabeprazole
• Young Adult