The effect of prostaglandin E2 on duodenal ulcer healing

Oral prostaglandin E2 (PGE2) has specific protective effects so called cytoprotection on the gastrointestinal mucosa that are independent of the acid secretion. This has recently been documented in man. A clinical study was performed to test whether this mucosal reinforcing property also could be used to accelerate duodenal ulcer healing. Twenty-eight patients with endoscopically confirmed duodenal ulcers were randomized to treatment with PGE2 0.5 mg three times daily and 1 mg at night or to placebo under double-blind conditions during a four week period. To reduce antacid consumption a fluid placebo antacid was given regularly. An active antacid could be used for pain relief. Healing rate was assessed with repeated endoscopies after 2 and 4 weeks. The treatment groups were comparable with respect to age, duration of ulcer history and present ulcer symptoms, smoking habits, family history, gastric acid secretory rate and number of patients with blood group 0. There was a slight difference in sex distribution. 2 mg PGE2 did not reduce pentagastrin-stimulated acid secretion in five of the patients. After the treatment significantly more in the PGE2-group (12/14, 86%) had healed than in the placebo-group (6/14, 43% P less than 0.05). There was no difference in pain relief between PGE2 and placebo-treated. The antacid consumption was very low in both PGE2 and placebo-treated. No significant side effects or changes in laboratory test-results were recorded. It is suggested that the cytoprotective effect of PGE2 can be used to accelerate healing of duodenal ulcer.