Roth S, Bennett R, Caldron P, Hartman R, Mitchell C, Doucette M, Ekholm B, Goldlust B, Lee E, Wilson R
Arthritis Center, Arizona Institutes, Phoenix 85102.
Semin Arthritis Rheum. 1990 Feb;19(4 Suppl 2):11-9.
This randomized, investigator-blinded, parallel group endoscopic study evaluated the effects of salsalate and naproxen on the gastroduodenal mucosa over a 3-month period in patients with RA. Using therapeutic doses of the drugs, 8 of 21 patients (38%) in the naproxen group had endoscopically shown active ulcers (seven patients) or diffuse erosions (one patient), whereas none of the 18 patients treated with salsalate (0%) had such lesions (P = .003). Five of the eight naproxen-treated patients with evidence of GI damage were asymptomatic at the time of endoscopic verification of their lesions. The most significant disadvantage of salsalate was its higher incidence of otologic problems accounting for six of the nine discontinuations with salsalate. However, the findings of this study suggest that patients receiving salsalate are at lower risk for developing significant gastropathy than those treated with naproxen. The relative benefit-to-risk ratio of salsalate indicates that this drug should be considered as a significant alternative NSAID therapy.
这项随机、研究者设盲、平行组内镜研究评估了在3个月期间，水杨酸盐和萘普生对类风湿性关节炎（RA）患者胃十二指肠黏膜的影响。使用药物治疗剂量时，萘普生组21例患者中有8例（38%）在内镜检查中显示有活动性溃疡（7例患者）或弥漫性糜烂（1例患者），而接受水杨酸盐治疗的18例患者中无一例（0%）有此类病变（P = 0.003）。8例经萘普生治疗且有胃肠道损伤证据的患者中，有5例在其病变经内镜证实时无症状。水杨酸盐最显著的缺点是其耳科问题发生率较高，9例因水杨酸盐停药的患者中有6例是由此导致。然而，本研究结果表明，接受水杨酸盐治疗的患者发生严重胃病的风险低于接受萘普生治疗的患者。水杨酸盐相对的效益风险比表明，该药物应被视为一种重要的非甾体抗炎药替代疗法。
