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Proton‐pump inhibitor therapy for acetylsalicylic acid associated upper gastrointestinal symptoms: a randomized placebo‐controlled trial
Author(s) -
Laheij R. J. F.,
. Van Rossum L. G. M,
Jansen J. B. M. J.,
Verheugt F. W. A.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01656.x
Subject(s) - medicine , heartburn , proton pump inhibitor , placebo , gastroenterology , nausea , rabeprazole , aspirin , bloating , epigastric pain , omeprazole , odds ratio , randomization , esophagitis , randomized controlled trial , vomiting , reflux , disease , alternative medicine , pathology
Summary Objective : Patients using acetylsalicylic acid (aspirin) have an increased risk of upper gastrointestinal discomfort. The aim of this study was to assess whether gastric acid suppression improves upper gastrointestinal symptoms in patients using low‐dose aspirin for cardiovascular disease. Methods : In a double‐blind, placebo‐controlled randomised trial, 150 patients using low‐dose (80 mg) acetylsalicylic acid with upper gastrointestinal symptoms who had been admitted at the Coronary Care Unit of the University Medical Center Nijmegen were assigned to treatment with rabeprazole (20 mg once daily) or placebo for 4 weeks. Treatment success, defined as complete upper gastrointestinal symptom relief, could be evaluated in 143 patients. Results : At 4 weeks after randomization, 34 of the 73 patients assigned to rabeprazole therapy (47%) as compared with 30 of the 70 patients given placebo (43%) reported complete upper gastrointestinal symptom relief ( P = 0.54). Rabeprazole therapy did lead to a 52% improvement of heartburn symptoms [25% vs. 16%; odds ratio (OR) 0.48, 95% confidence interval (CI): 0.24–0.97]. Epigastric pain, regurgitation, bloating and nausea symptoms did not statistically change after treatment. Patients with a history of dyspepsia more often reported treatment success in comparison to those without (75% vs. 40%; OR 0.25, 95% CI: 0.09–0.70). Conclusions : Proton‐pump inhibitor therapy significantly reduced heartburn, but not other acetylsalicylic acid associated symptoms.