A prospective endoscopic study of the effect of Orudis and Oruvail on the upper gastrointestinal tract, in patients with osteoarthritis.

The effect of ketoprofen, a nonsteroidal anti-inflammatory drug, was tested on the upper gastrointestinal tract (UGIT) in patients with osteoarthritis. The drug was given in two forms; as simple ketoprofen (Orudis) and as a slow release preparation (Oruvail), when the drug was not released into the stomach, but into the small intestine. These formulations were compared with indomethacin for endoscopically proven damage to the UGIT. Orudis and Oruvail produced similar damage to previously normal UGITs over 56 days; each formulation produced about a 50% incidence of ulceration and inflammation. Indomethacin, by comparison produced less damage. The results suggested that the direct action of ketoprofen (barrier breaking effect) adds little to the mechanism of gastric cytotoxicity of this drug, which may be assumed to be predominantly caused by a systemic effect of ketoprofen on gastric cytoprotective mechanisms.