Misoprostol cures NSAID/aspirin-induced small bowel injuries

Use of misoprostol can effectively mend small bowel injuries (SBI) caused by NSAIDs or aspirin, reports a recent study.

“The frequency of SBI has increased due to the increased use of NSAIDs or aspirin,” the investigators said. “This study was a systematic review and meta-analysis to compare drugs effective for SBIs caused by NSAIDs or aspirin use.”

The databases of Embase, Medline, and Cochrane were searched for randomized controlled trials (RCTs) until February 2023. The investigators extracted data on changes in the number of erosions or ulcers in the jejunum or ileum seen through capsule endoscopy in patients taking NSAIDs or aspirin and administration of various mucoprotectants.

In addition, the therapeutic or preventive efficacy of these drugs were examined. Finally, the Risk of Bias 2.0 was used to assess methodological bias in selected studies.

Eighteen RCTs of drugs effective for NSAID- or aspirin-induced SBIs met the inclusion criteria. These drugs included rebamipide, misoprostol, geranylgeranylacetone, and probiotics.

Based on the meta-analysis, mucoprotectants were effective in treating NSAID users who developed SBIs, particularly misoprostol (mean difference, –9.88, 95 percent confidence interval [CI], –13.26 to –6.50). Additionally, in the general population, rebamipide was the mucoprotectant that could prevent SBIs caused by aspirin or NSAID (mean difference, –1.85, 95 percent CI, –2.74 to –0.96).