Key result
Sucralfate 1 g four times daily significantly reduced aspirin-associated spontaneous and biopsy-induced intragastric bleeding, but did not affect acute gastric mucosal injury.
Why the study?
Does sucralfate reduce aspirin-induced mucosal injury and intragastric bleeding in healthy volunteers?
RCT (n=24)
Does sucralfate reduce aspirin-induced mucosal injury and intragastric bleeding in healthy volunteers?
Sucralfate reduces aspirin-associated intragastric bleeding but does not prevent acute gastric mucosal injury.
Sucralfate may reduce aspirin-related bleeding without preventing mucosal injury; challenges cytoprotection assumptions and leaves open patient outcomes.
BACKGROUND: Sucralfate does not have potent anti-ulcerogenic actions in users of non-steroidal anti-inflammatory drugs (NSAIDs). However, sucralfate may influence intragastric haemostasis favourably. AIM: To investigate separately the effects of sucralfate on acute gastric and duodenal injury and on changes in intragastric bleeding induced by aspirin. METHOD: On three occasions, 24 healthy volunteers received three days' treatment with aspirin 900 mg twice daily together with placebo, sucralfate 2 g twice daily or sucralfate 1 g four times daily. Injury was assessed endoscopically and bleeding by spontaneous and biopsy induced bleeding intragastric washings. Ex vivo prostaglandin E2 (PGE2) synthesis and serum thromboxane were measured by using radioimmunoassay. RESULTS: Aspirin significantly inhibited ex vivo gastric mucosal PGE2 synthesis, reduced serum thromboxane, caused gastric erosions, and increased spontaneous and biopsy induced bleeding. Sucralfate had no significant effects on endoscopic injury but sucralfate 1 g four times daily significantly reduced spontaneous and biopsy induced bleeding. Similar trends were seen with sucralfate 2 g twice daily but the results were less consistent. CONCLUSION: Sucralfate does not affect aspirin induced acute gastric mucosal injury but reduces aspirin associated intragastric bleeding.
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Hudson et al. (1997) conducted an RCT in Healthy volunteers (n=24). Sucralfate vs. Placebo was evaluated on Acute gastric and duodenal injury and changes in intragastric bleeding. Sucralfate 1 g four times daily significantly reduced aspirin-associated spontaneous and biopsy-induced intragastric bleeding, but did not affect acute gastric mucosal injury.
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