{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T06:22:43Z","timestamp":1789885363572,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,5,6]],"date-time":"2009-05-06T00:00:00Z","timestamp":1241568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:sec><jats:label\/><jats:p> <jats:bold>WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT<\/jats:bold> <\/jats:p><jats:p>\u2022\u2003Whether glucocorticoids induce gastric mucosal injury remains uncertain, and <jats:italic>Helicobacter pylori<\/jats:italic> infection in steroid users has not been well evaluated in the past.<\/jats:p><jats:p>\u2022\u2003Pulse methylprednisolone therapy with the very high dose of steroid that is 100 times larger than the physiological dose will be a special model to evaluate whether glucocorticoids induce gastric mucosal injury.<\/jats:p><jats:p> <jats:bold>WHAT THIS STUDY ADDS<\/jats:bold> <\/jats:p><jats:p>\u2022\u2003Use of nonsteroidal anti\u2010inflammatory drugs\/aspirin, but not <jats:italic>H. pylori<\/jats:italic> infection, increases gastric mucosal injury in systemic lupus erythematosus patients receiving pulse methylprednisolone therapy.<\/jats:p><jats:p>\u2022\u2003Very high\u2010dose steroids <jats:italic>de novo<\/jats:italic> seem not to induce gastric mucosal injury in these patients.<\/jats:p><jats:p>\u2022\u2003However, a larger, case\u2010controlled study enrolling a heterogeneous population is needed to clarify the role of glucocorticoids in gastric mucosal injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>AIMS<\/jats:title><jats:p>Whether glucocorticoids induce gastric mucosal injury remains uncertain. We investigated whether very high\u2010dose steroids caused gastric mucosal injury in systemic lupus erythematous (SLE) patients and evaluated the possible risk factors for mucosal injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>In this prospective paired study, 67 SLE patients who had received pulse methylprednisolone therapy were enrolled. Each patient underwent endoscopic examination and tissue and blood sampling before and after pulse steroid therapy. Mucosal injury was diagnosed if the follow\u2010up injury scale was higher than the initial scale. Examined parameters included <jats:italic>Helicobacter pylori<\/jats:italic> infection, cyclooxygenase (COX)\u20101 and COX\u20102 activity, and current nonsteroidal anti\u2010inflammatory drug (NSAID) usage including aspirin.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Eleven (16.4%) of 67 cases who developed gastric mucosal injury after pulse therapy had significantly higher rates of peptic ulcer history, NSAID\/aspirin use, lower gastric thromboxane B<jats:sub>2<\/jats:sub> and prostaglandin E<jats:sub>2<\/jats:sub> levels when compared with cases without gastric mucosal injury (<jats:italic>P<\/jats:italic> &lt; 0.05). Infection by <jats:italic>H. pylori<\/jats:italic> was not a risk factor for gastric mucosal injury. Multivariate logistic regression analysis showed that NSAID\/aspirin use was the only risk factor for gastric mucosal injury in these patients (odds ratio 26.99, 95% confidence interval 4.91, 148.57, <jats:italic>P<\/jats:italic> &lt; 0.0001). Pulse steroid therapy alone did not induce gastric mucosal injury in fifty SLE patients without taking any NSAID\/aspirin.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Use of NSAIDs\/aspirin, but not <jats:italic>H. pylori<\/jats:italic> infection, increases gastric mucosal injury in SLE patients receiving pulse methylprednisolone therapy. Very high\u2010dose steroids <jats:italic>de novo<\/jats:italic> seem not to induce gastric mucosal injury in these patients. A larger case\u2010controlled study enrolling a heterogeneous population is needed to clarify the role of glucocorticoids in gastric mucosal injury.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2125.2009.03445.x","type":"journal-article","created":{"date-parts":[[2009,5,6]],"date-time":"2009-05-06T09:20:15Z","timestamp":1241601615000},"page":"252-259","source":"Crossref","is-referenced-by-count":27,"title":["Gastric mucosal injury in systemic lupus erythematosus patients receiving pulse methylprednisolone 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