Preventive effect of ecabet sodium on low-dose aspirin-induced small intestinal mucosal injury: a randomized, double-blind, pilot study

K, Ota; Takeuchi, Toshihisa; Kojima, Yuichi; Harada, Satoshi; Hirata, Yuki; Sugawara, Noriaki; Nouda, Sadaharu; Kakimoto, Kazuki; Kuramoto, Takanori; Higuchi, Kazuhide

doi:10.1186/s12876-018-0923-7

Cited by 12 publications

(13 citation statements)

References 28 publications

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“…Rebamipide 49,50 and irsogladine 50,51 have demonstrated superiority to placebo in both prevention and treatment of NSAID-induced enteropathy, whereas polaprezinc showed efficacy only in ulcer healing 52 and teprenone (geranylgeranylacetone) 53 and ecabet sodium only in prevention. 54 Nevertheless, none of these medications have been proven to be effective in SB bleeding ulcers outside of misoprostol. 19 ' 48…”

Section: Approach To Treatment and Preventionmentioning

confidence: 99%

Review article: drug‐induced small bowel injury

Hamdeh

Micic

Hanauer

2021

Aliment Pharmacol Ther

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Background: Drug-induced gastrointestinal injury has been increasingly reported, but its exact incidence is not known. The small and large intestines represent the most affected sites of injury, accounting for 20%-40% of all gastrointestinal side effects. Aim:To provide an updated literature review detailing medications linked to the development of small bowel injury. Methods:We conducted a literature search on PubMed from its inception to May 1, 2021. We included English-language original studies, meta-analyses, systematic reviews, review articles and case reports.Results: Drug-induced enteropathy can range from asymptomatic histological changes resulting in a subtle, self-limited disease to a chronic inflammatory condition mimicking inflammatory bowel disease, or bowel perforation. Endoscopy can demonstrate erythema, mucosal friability, oedema, erosions, ulcers or strictures in severe cases. Histology may include mucosal erosions and ulcerations, focal active enteritis, villous atrophy, epithelial apoptosis or necrotising enteritis. A well-established association has been found with the use of nonsteroidal anti-inflammatory drugs, immunosuppressants, chemotherapeutic agents, antibiotics, immunotherapies, etanercept and olmesartan. Possible associations have been reported with other biologic agents, medications used for glycemic control, antihypertensives, cholinesterase inhibitors, potassium and iron supplements, with conflicting data regarding contraceptives/hormonal therapy and isotretinoin. Conclusion:Physicians should be aware of the manifestations of drug-induced enteropathy as early recognition can lead to prompt discontinuation of the offending therapy and, therefore, a reduced risk of future complications.

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Section: Approach To Treatment and Preventionmentioning

confidence: 99%

Review article: drug‐induced small bowel injury

Hamdeh

Micic

Hanauer

2021

Aliment Pharmacol Ther

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“…Studies using capsule endoscopy have shown that rebamipide also prevented both NSAIDs-and LDA-induced enteropathy in healthy volunteers [22,115] and promoted the healing of intestinal mucosal breaks in chronic users of NSAIDs and LDA [116,117]. Other muco-protective drugs such as irsogladine [118], polaprezinc [119], geranylgeranylacetone [120], and ecabet sodium [121] have demonstrated their therapeutic potential for NSAIDs/LDA-induced enteropathy. However, similar to other drugs besides misoprostol, none of these muco-protective drugs have been proven to be effective on clinically significant small intestinal injuries (Table 2).…”

Section: Gastric Muco-protective Drugsmentioning

confidence: 99%

Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: a comprehensive review

2019

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Recent advances in small-bowel endoscopy such as capsule endoscopy have shown that non-steroidal antiinflammatory drugs (NSAIDs) frequently damage the small intestine, with the prevalence rate of mucosal breaks of around 50% in chronic users. A significant proportion of patients with NSAIDs-induced enteropathy are asymptomatic, but some patients develop symptomatic or complicated ulcers that need therapeutic intervention. Both inhibition of prostaglandins due to the inhibition of cyclooxygenases and mitochondrial dysfunction secondary to the topical effect of NSAIDs play a crucial role in the early process of injury. As a result, the intestinal barrier function is impaired, which allows enterobacteria to invade the mucosa. Gram-negative bacteria and endogenous molecules coordinate to trigger inflammatory cascades via Toll-like receptor 4 to induce excessive expression of cytokines such as tumor necrosis factor-a and to activate NLRP3 inflammasome, a multiprotein complex that processes pro-interleukin-1b into its mature form. Finally, neutrophils accumulate in the mucosa, resulting in intestinal ulceration. Currently, misoprostol is the only drug that has a proven beneficial effect on bleeding small intestinal ulcers induced by NSAIDs or low-dose aspirin, but its protection is insufficient. Therefore, the efficacy of the combination of misoprostol with other drugs, especially those targeting the innate immune system, should be assessed in the next step. Keywords Non-steroidal anti-inflammatory drug Á Lowdose aspirin Á Enteropathy Á Innate immunity Á Misoprostol Abbreviations NSAID Non-steroidal anti-inflammatory drug RA Rheumatoid arthritis

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“…Apart from the above agents, there are several other drugs such as sulphasalazine, 42 ecabet sodium, 43 egualen sodium, 44 curcumin, 95,96 and muscovite, 45 which were reported to have a preventive effect on NSAIDs-induced small intestine injury. However, data is very limited for these agents.…”

Section: Othermentioning

confidence: 99%

Potential Strategies in the Prevention of Nonsteroidal Anti-inflammatory Drugs-Associated Adverse Effects in the Lower Gastrointestinal Tract

Guo

Leung

2020

Gut and Liver

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With the increasing use of nonsteroidal anti-inflammatory drugs (NSAIDs), the incidence of lower gastrointestinal (GI) complications is expected to increase. However, unlike upper GI complications, the burden, pathogenesis, prevention and treatment of NSAID-associated lower GI complications remain unclear. To date, no cost-effective and safe protective agent has been developed that can completely prevent or treat NSAID-related lower GI injuries. Selective COX-2 inhibitors, misoprostol, intestinal microbiota modulation, and some mucoprotective agents have been reported to show protective effects on NSAID-induced lower GI injuries. This review aims to provide an overview of the current evidence on the prevention of NSAID-related lower GI injuries. (Gut Liver 2020;14:179-189)

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Preventive effect of ecabet sodium on low-dose aspirin-induced small intestinal mucosal injury: a randomized, double-blind, pilot study

Cited by 12 publications

References 28 publications

Review article: drug‐induced small bowel injury

Review article: drug‐induced small bowel injury

Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: a comprehensive review

Potential Strategies in the Prevention of Nonsteroidal Anti-inflammatory Drugs-Associated Adverse Effects in the Lower Gastrointestinal Tract

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