Digestive Diseases and Sciences

, Volume 31, Supplement 2, pp 68S–74S | Cite as

Prostaglandin E1 (Misoprostol) overcomes the adverse effect of chronic cigarette smoking on duodenal ulcer healing

  • Shiu-Kum Lam
  • Wan-Yee Lau
  • Tat-Kuen Choi
  • Ching-Lung Lai
  • Anna S. F. Lok
  • Wai-Mo Hui
  • Matthew M. T. Ng
  • Samuel K. Y. Choi
Prostaglandins in Peptic Ulcer Disease Clinical Efficacy of Misoprostol

Abstract

Chronic cigarette smoking adversely affects duodenal ulcer healing despite treatment by potent gastric acid-reducing agents. Prostaglandins of the E series possess antisecretory and cytoprotective properties and theoretically offer advantages over existing therapeutic agents. A double-blind randomized study was performed to compare complete duodenal ulcer healing as assessed by endoscopies every two weeks for up to 12 weeks. Two hundred twenty-nine patients were randomized to receive misoprostol, an orally stable synthetic derivative of prostaglandin E1, in 200-μg or 300-μg qid dosages, or placebo. Life-table analysis showed that (1) both regimens of misoprostol were significantly more effective than placebo, achieving healing rates of 61% and 71%, respectively, at four weeks, and (2) cigarette smoking significantly impaired healing by placebo but not by misoprostol. In fact, the time-healing curves of smokers and nonsmokers on the higher dose of misoprostol completely overlapped. Furthermore, delayed treatment and large ulcer diameter adversely affected healing by misoprostol in smokers, whereas in nonsmokers, high basal and maximal acid output were unfavorable. Misoprostol is recommended for the treatment of duodenal ulcer, particularly in chronic smokers early in a given period of symptoms.

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Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Shiu-Kum Lam
    • 1
    • 2
    • 3
  • Wan-Yee Lau
    • 1
    • 2
    • 3
  • Tat-Kuen Choi
    • 1
    • 2
    • 3
  • Ching-Lung Lai
    • 1
    • 2
    • 3
  • Anna S. F. Lok
    • 1
    • 2
    • 3
  • Wai-Mo Hui
    • 1
    • 2
    • 3
  • Matthew M. T. Ng
    • 1
    • 2
    • 3
  • Samuel K. Y. Choi
    • 1
    • 2
    • 3
  1. 1.Department of SurgeryUniversity of Hong KongHong Kong
  2. 2.Government Surgical UnitQueen Mary HospitalHong Kong
  3. 3.Department of MedicineUniversity of Hong KongHong Kong

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