rioprostil and Peptic-Ulcer

The new prostaglandin E1 analogue, rioprostil, significantly accelerates healing and the elimination of pain in cases of peptic ulcer. The anti-ulcerous potency of this prostaglandin is equivalent to that of cimetidine. In comparison with ranitidine, there is a positive trend in favour of the H2-receptor antagonist, ranitidine, which has a more pronounced antisecretory effect than rioprostil. The differences in the healing rates during treatment with rioprostil and ranitidine are statistically significant in some cases, whereas those relating to pain alleviation are not. In contrast, the therapeutic efficacy of the two substances is almost identical in cases of Ulcus ventriculi. Rioprostil can be used with much the same success as ranitidine for preventing the recurrence of duodenal ulcers. The frequency of diarrhoea during rioprostil treatment, 300 micrograms b.d. and 600 micrograms nocte, is approximately 10%. In only about 1% of the patients does the rioprostil treatment have to be discontinued because of this adverse reaction.

Topics: Anti-Ulcer Agents; Cimetidine; Clinical Trials as Topic; Humans; Peptic Ulcer; Prostaglandins E; Prostaglandins, Synthetic; Ranitidine; Rioprostil

This investigation examined the effect of rioprostil, a primary alcohol prostaglandin E1 analog, on betazole-stimulated gastric acid secretion and on basal and food-stimulated (postprandial) serum gastrin levels in gastric fistula dogs. Rioprostil inhibited betazole-stimulated gastric acid secretion with an ED50 of 16 (10-24) micrograms/kg, intragastrically. A near-maximal gastric antisecretory dose (100 micrograms/kg, intragastrically) had no effect on basal serum gastrin levels but significantly attenuated the rapid rise in serum gastrin which follows feeding, a result different from that reported for other prostaglandin E1 analogs. A nonantisecretory dose of rioprostil (1.0 micrograms/kg, intragastrically) also attenuated the rise in postprandial serum gastrin. An antigastrin effect using a nonantisecretory dose of an antiulcer agent has not been reported previously and may indicate that rioprostil has a direct inhibitory effect on secretion of gastrin. The ability of rioprostil to inhibit gastric acid secretion and decrease postprandial peak serum gastrin levels, coupled with previously established cytoprotective efficacy, makes it an attractive clinical candidate for the treatment and prevention of peptic ulcer disease.

Topics: Animals; Anti-Ulcer Agents; Depression, Chemical; Dogs; Female; Gastric Acid; Gastric Fistula; Gastrins; Gastrointestinal Contents; Peptic Ulcer; Prostaglandins E; Radioimmunoassay; Rioprostil

The new prostaglandin E1 analogue, rioprostil, significantly accelerates healing and the elimination of pain in cases of peptic ulcer. The anti-ulcerous potency of this prostaglandin is equivalent to that of cimetidine. In comparison with ranitidine, there is a positive trend in favour of the H2-receptor antagonist, ranitidine, which has a more pronounced antisecretory effect than rioprostil. The differences in the healing rates during treatment with rioprostil and ranitidine are statistically significant in some cases, whereas those relating to pain alleviation are not. In contrast, the therapeutic efficacy of the two substances is almost identical in cases of Ulcus ventriculi. Rioprostil can be used with much the same success as ranitidine for preventing the recurrence of duodenal ulcers. The frequency of diarrhoea during rioprostil treatment, 300 micrograms b.d. and 600 micrograms nocte, is approximately 10%. In only about 1% of the patients does the rioprostil treatment have to be discontinued because of this adverse reaction.

Topics: Anti-Ulcer Agents; Cimetidine; Clinical Trials as Topic; Humans; Peptic Ulcer; Prostaglandins E; Prostaglandins, Synthetic; Ranitidine; Rioprostil

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Humans; Peptic Ulcer; Prostaglandins E; Prostaglandins, Synthetic; Rioprostil; Stomach Ulcer

Prostaglandin-E-analogues inhibit gastric acid secretion after oral administration. Therefore, these drugs are tested in clinical trials and two of them- misoprostol and rosaprostol-has recently been registered. With regard to healing rate of peptic ulcer and improvement of clinical signs and symptoms the prostaglandin analogues are superior to placebo but only equally effective or even slightly inferior to H2-receptor blockers. The relapse rates following successful therapy with prostaglandin analogues are similar to that with H2-blockers. Side effects such as diarrhea or uterotropic actions will probably limit their broad application. The exact therapeutic effectiveness of prostaglandin analogues in treatment of peptic ulcer remains to be evaluated in greater detail. As in the treatment of peptic ulcer disease prostaglandin-analogues are only effective in preventing NOSAC-induced peptic lesions when given in antisecretory doses.

Topics: Alprostadil; Anti-Ulcer Agents; Cimetidine; Enprostil; Humans; Misoprostol; Peptic Ulcer; Prostaglandins E; Prostaglandins E, Synthetic; Prostaglandins, Synthetic; Recurrence; Rioprostil; Wound Healing