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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Research

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin can cause gastroduodenal injury.
  • Prostaglandins play a role in protecting the gastric mucosa.

Purpose of the Study:

  • To compare the gastroduodenal mucosal injury, prostaglandin content, and plasma prostaglandin concentrations of salsalate and aspirin in healthy volunteers.

Main Methods:

  • Healthy volunteers received oral salsalate (3.0 g/day), aspirin (3.9 g/day), or placebo for 7.5 days.
  • Gastroduodenal mucosa was assessed endoscopically.
  • Mucosal and plasma prostaglandin levels were measured.

Main Results:

  • Aspirin caused significant gastroduodenal injury, while salsalate and placebo did not.
  • Aspirin reduced mucosal prostaglandin F2a and E2 by over 90% and plasma prostaglandin F2a by 58%.
  • Salsalate did not significantly alter mucosal prostaglandin levels and only slightly reduced plasma prostaglandin F2a (11%).

Conclusions:

  • Salsalate causes significantly less gastroduodenal mucosal damage than aspirin at equivalent serum salicylate concentrations.
  • Salsalate's reduced gastrointestinal toxicity may be due to its lack of inhibition of mucosal prostaglandin synthesis.