Geranylgeranylacetone protects against small-intestinal injuries induced by diclofenac in patients with rheumatic diseases: A prospective randomized study

Background: We aimed to explore the effect of geranylgeranylacetone on small-intestinal mucosal injuries induced by diclofenac sodium in patients with rheumatic diseases. Methods: The patients were randomly divided into two groups in our prospective study. The patients in the geranylgeranylacetone group received diclofenac sodium plus geranylgeranylacetone, and those in the control group received only diclofenac sodium for 12 weeks. We examined small-intestinal mucosal injuries using capsule endoscopy before and after treatment. Results: There were no significant differences between geranylgeranylacetone (n = 21, male: 42.9%; age: 31.0 +/- 9.0 year) and control (n = 19, male: 68.4%; age: 31.0 +/- 11.0 year) groups in terms of the numbers of patients with petechiae/red spots, denuded areas and mucosal breaks at baseline capsule endoscopy. After treatment, the numbers of patients with denuded areas (chi(2) = 0.000, P = 1.000) and mucosal breaks (chi(2) = 1.750, P = 0.186) did not increase in the geranylgeranylacetone group. However, the numbers of patients with petechiae/red spots (chi(2) = 5.216, P = 0.022), denuded areas (chi(2) = 8.686, P = 0.003) and muco sal breaks ( chi(2) = 7.795,P = 0.005) increased after treatment in the control groups. Geranylgeranylacetone improved both the Lewis score (Z = -2.459, P = 0.017) and degree (chi(2) = 5.414, P = 0.020) on capsule endoscopy 12 weeks later. Conclusions: In patients with rheumatic diseases, geranylgeranylacetone is effective for protecting against small-intestinal mucosal injuries induced by diclofenac sodium. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.