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Diclofenac delays healing of gastroduodenal mucosal lesions

Double-blind, placebo-controlled endoscopic study in healthy volunteers

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Abstract

The effects of the water-soluble and delayed-release formulations of a nonsteroidal antiinflammatory drug, diclofenac, on the healing of gastroduodenal mucosal lesions were compared in a double-blind, double cross-over, placebo-controlled endoscopic study conducted in 14 healthy volunteers. Severe endoscopic lesions (petechiae, erosions, ulcers, and esophageal candidiasis) were found only in the group taking the soluble formulation of diclofenac (P<0.05 vs placebo). The endoscopic healing of biopsies at one week was delayed by both preparations in comparison to placebo (P<0.05 vs placebo). Neither formulation produced significantly more histological inflammation or minor endoscopic lesions (erythema, red striae) than placebo. Both formulations were equally well tolerated and produced no more symptoms than placebo. This study suggests that soluble diclofenac acts topically to delay gastroduodenal healing and produce gastroduodenal injury; it thus provides a model for future studies of the production, perpetuation, and healing of peptic lesions.

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Authors and Affiliations

  1. Division de Gastroentérologie, CHUV/PMU, CH-1011, Lausanne, Switzerland

    Philippe Stadler MD, David Armstrong MD, Doron Margalith MD, Emilia Saraga MD, Manfred Stolte MD, Paulo Lualdi PhD, Giuseppe Mautone PhD &  Andre Louis Blum MD

  2. Institut de Pathologie, CH-1011, Lausanne, Switzerland

    Philippe Stadler MD, David Armstrong MD, Doron Margalith MD, Emilia Saraga MD, Manfred Stolte MD, Paulo Lualdi PhD, Giuseppe Mautone PhD &  Andre Louis Blum MD

  3. Institut für Pathologie, D-8580, Bayreuth, Germany

    Philippe Stadler MD, David Armstrong MD, Doron Margalith MD, Emilia Saraga MD, Manfred Stolte MD, Paulo Lualdi PhD, Giuseppe Mautone PhD &  Andre Louis Blum MD

  4. Institut Biochimique SA, Lugano, Switzerland

    Philippe Stadler MD, David Armstrong MD, Doron Margalith MD, Emilia Saraga MD, Manfred Stolte MD, Paulo Lualdi PhD, Giuseppe Mautone PhD &  Andre Louis Blum MD

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  1. Philippe Stadler MD
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Supported in part by a grant from IBSA, Lugano, Switzerland, and in part by SNF grant 32-26369.89

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Stadler, P., Armstrong, D., Margalith, D. et al. Diclofenac delays healing of gastroduodenal mucosal lesions. Digest Dis Sci 36, 594–600 (1991). https://doi.org/10.1007/BF01297025

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