A comparative study of DA-9601 and misoprostol for prevention of NSAID-associated gastroduodenal injury in patients undergoing chronic NSAID treatment

• Published in: Archives of pharmacal research 2014, 37(10), , pp.1308-1316
• Main Authors: Lee, Oh Young, Kang, Dae-Hwan, Lee, Dong Ho, Chung, Il-Kwun, Jang, Jae-Young, Kim, Jin-Il, Cho, Jin-Woong, Rew, Jong-Sun, Lee, Kang-Moon, Kim, Kyoung Oh, Choi, Myung-Gyu, Lee, Sang-Woo, Lee, Soo-Teik, Kim, Tae-Oh, Shin, Yong-Woon, Seol, Sang-Yong
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Anti-Ulcer Agents - adverse effects; Anti-Ulcer Agents - therapeutic use; Diclofenac - adverse effects; Diclofenac - analogs & derivatives; Diclofenac - therapeutic use; Double-Blind Method; Female; Humans; Medicine; Middle Aged; Misoprostol - adverse effects; Misoprostol - therapeutic use; Peptic Ulcer - chemically induced; Peptic Ulcer - drug therapy; Pharmacology/Toxicology; Pharmacy; Plant Extracts - adverse effects; Plant Extracts - therapeutic use; Research Article; Young Adult; 약학
• ISSN: 0253-6269; 1976-3786
• DOI: 10.1007/s12272-014-0408-3

Misoprostol is reported to prevent non-steroidal anti-inflammatory drug (NSAID)-associated gastroduodenal complications. There is, however, limited information regarding the efficacy of DA-9601 in this context. We performed a comparative study on the relative efficacy of DA-9601 and misoprostol for prevention of NSAID-associated complications. In this multicenter, double-blinded, active-controlled, stratified randomized, parallel group, non-inferiority trial, 520 patients who were to be treated with an NSAID (aceclofenac, 100 mg, twice daily) over a 4-week period were randomly assigned to groups for coincidental treatment with DA-9601 (60 mg, thrice daily) (236 patients for full analysis) or misoprostol (200 μg, thrice daily) (242 patients for full analysis). A total of 236 patients received DA-9601 and 242 received misoprostol. The primary endpoint was the gastric protection rate, and secondary endpoints were the duodenal protection rate and ulcer incidence rate. Endpoints were assessed by endoscopy after the 4-week treatment period. Drug-related adverse effects, including gastrointestinal (GI) symptoms, were also compared. At week 4, the gastric protection rates with DA-9601 and misoprostol were 81.4 % (192/236) and 89.3 % (216/242), respectively. The difference between the groups was −14.2 %, indicating non-inferiority of DA-9601 to misoprostol. Adverse event rates were not different between the two groups; however, the total scores for GI symptoms before and after administration were significantly lower in the DA-9601 group than in the misoprostol group (−0.2 ± 2.8 vs 1.2 ± 3.2; p