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Epidemiology of NSAID‐induced gastrointestinal problems and the role of cimetidine in their prevention
Author(s) -
GIERCKSKY KE.,
HUSBY G.,
RUGSTAD H. E.,
REVHAUG A.
Publication year - 1988
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 - 10.1111/j.1365-2036.1988.tb00763.x
Subject(s) - medicine , cimetidine , incidence (geometry) , perforation , gastrointestinal bleeding , gastroenterology , gastritis , duodenal ulcer , side effect (computer science) , epidemiology , stomach , physics , materials science , computer science , optics , punching , metallurgy , programming language
SUMMARY It is difficult to ascertain the incidence of gastrointestinal side‐effects associated with intake of non‐steroidal anti‐inflammatory drugs (NSAIDs). In retrospective studies, some NSAIDs have been reported to be associated with a higher incidence of gastrointestinal side‐effects than others. However, this has not been verified either in a prospective casereview study or in a large double‐blind study. Serious side‐effects, such as bleeding, perforation and heart failure, occur in approximately 1 % of patients using NSAIDs. One‐third of all patients receiving NSAIDs will have gastrointestinal complaints. Since at least 10% of patients terminate treatment with NSAIDs as a result of side‐effects, even reduction of those that are not life‐threatening would be of great benefit. H 2 ‐receptor antagonists have proved effective in ulcer treatment, and their use as prophylaxis against the side‐effects of NSAIDs is being widely studied. In a recent study, 63 patients who had experienced serious upper gastrointestinal side‐effects were given cimetidine while continuing their NSAID therapy. All but 4 of the 47 who had gastric or duodenal ulcer on first admission were healed at 8 weeks, and none of the remaining 16 with diffuse bleeding gastritis experienced further clinical episodes of bleeding or ulcer‐related dyspepsia.