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

Oh Young Lee, Dae Hwan Kang, Dong Ho Lee, Il Kwun Chung, Jae Young Jang, Jin Il Kim, Jin Woong Cho, Jong Sun Rew, Kang Moon Lee, Kyoung Oh Kim, Myung Gyu Choi, Sang Woo Lee, Soo Teik Lee, Tae Oh Kim, Yong Woon Shin, Sang Yong Seol

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9 Citations (Scopus)

Abstract

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 < 0.0001). DA-9601 is as effective as misoprostol in preventing NSAID-associated gastroduodenal complications, and has a superior adverse GI effect profile.

Original languageEnglish
Pages (from-to)1308-1316
Number of pages9
JournalArchives of pharmacal research
Volume37
Issue number10
DOIs
Publication statusPublished - 2014 Oct 1

Keywords

  • DA-9601(Stilen<sup>®</sup>)
  • Gastroduodenal injury
  • Misoprostol
  • NSAID-associated

ASJC Scopus subject areas

  • Molecular Medicine
  • Drug Discovery
  • Organic Chemistry

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  • Cite this

    Lee, O. Y., Kang, D. H., Lee, D. H., Chung, I. K., Jang, J. Y., Kim, J. I., Cho, J. W., Rew, J. S., Lee, K. M., Kim, K. O., Choi, M. G., Lee, S. W., Lee, S. T., Kim, T. O., Shin, Y. W., & Seol, S. Y. (2014). A comparative study of DA-9601 and misoprostol for prevention of NSAID-associated gastroduodenal injury in patients undergoing chronic NSAID treatment. Archives of pharmacal research, 37(10), 1308-1316. https://doi.org/10.1007/s12272-014-0408-3