Sucralfate therapy in NSAID bleeding gastropathy

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Medicine

Background:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently associated with gastric mucosal lesions.
• Long-term NSAID use can lead to gastrointestinal complications, including erosions and bleeding.
• Identifying effective treatments for NSAID-induced gastropathy is crucial for patient care.

Purpose of the Study:

• To evaluate the efficacy of sucralfate suspension in healing gastric mucosal lesions induced by chronic NSAID use.
• To compare the treatment outcomes of sucralfate versus placebo in a well-defined patient population.

Main Methods:

• A randomized, double-blind, placebo-controlled, multicenter study.
• Inclusion criteria: continuous NSAID use for ≥2 months, positive fecal occult blood (FOB), and mild to moderate endoscopic lesions (Lanza grades 2-4).
• Patients received 2 g sucralfate suspension or placebo twice daily for 6 weeks, with NSAIDs continued as prescribed.

Main Results:

• 68% of patients treated with sucralfate achieved complete lesion healing (Lanza grade 0) versus 35% in the placebo group (P=0.042).
• Sucralfate treatment resulted in significantly improved Lanza grades compared to placebo (P=0.022).
• The study included 50 patients (25 sucralfate, 25 placebo).

Conclusions:

• Chronic administration of sucralfate suspension is effective in reducing NSAID-induced gastric erosions.
• Sucralfate offers a significant therapeutic benefit for patients with NSAID-related gastropathy confirmed by FOB and endoscopy.
• The findings support sucralfate as a treatment option for NSAID-induced mucosal injury.