Does famotidine have similar efficacy to misoprostol in the treatment of non-steroidal anti-inflammatory drug-induced gastropathy?

The study aimed to evaluate the efficacy of famotidine, an H2 receptor blocker, and misoprostol, a prostaglandin E analogue, in the treatment of non-steroidal anti-inflammatory drug-induced (NSAID) gastropathy in arthritic patients. A total of 128 patients receiving piroxicam, sulindac, indomethacin, naproxen, tolmetin and aspirin were enrolled in the study. Gastroscopic examination was performed at the beginning and after eight weeks of randomised famotidine or misoprostol treatment. A standard scoring method for gastroscopic finding was applied. Forty-four patients with scores 1-3 were classified as group A; while the other 84 with score 4 (ulcer) were placed in group B. In group A, 26 received famotidine and 18 misoprostol. In group B, 36 received famotidine and 48 misoprostol. Biopsy specimens taken from the rim of the ulcer with adjacent normal mucosa were coded and tested for Helicobacter pylori. In group A, all but two patients taking famotidine recovered from NSAID gastropathy, and there was no statistical significance between the two drugs. In group B, all but four patients receiving famotidine improved and there was no statistical significance between the two subgroups for complete healing rate. The prevalence of H. pylori was 36.9%, lower than that in the general population. It was concluded that famotidine and misoprostol have similar efficacy in the treatment of NSAID gastropathy.