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A clinical study of Japanese patients with ulcer induced by low‐dose aspirin and other non‐steroidal anti‐inflammatory drugs
Author(s) -
Nakashima S.,
Arai S.,
Mizuno Y.,
Yoshino K.,
Ando S.,
Nakamura Y.,
Sugawara K.,
Koike M.,
Saito E.,
Naito M.,
Nakao M.,
Ito H.,
Hamaoka K.,
Rai F.,
Asakura Y.,
Akamatu M.,
Fujimori K.,
Inao M.,
Imai Y.,
Ota S.,
Fujiwara K.,
Shiibashi M.
Publication year - 2005
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.1365-2036.2005.02476.x
Subject(s) - medicine , aspirin , gastroenterology , diclofenac , incidence (geometry) , prospective cohort study , lesion , duodenal ulcer , surgery , pharmacology , physics , optics
Summary Background : The incidence and severity of non‐steroidal anti‐inflammatory drugs (NSAIDs)‐induced gastro‐duodenal ulcer have not been extensively studied in Japan. Aim : We performed a prospective study to clarify NSAIDs‐induced gastro‐duodenal injury, focusing especially on low‐dose aspirin (L‐A). Methods : Two hundred and thirty‐eight patients with bleeding peptic ulcers admitted to our hospital. History of taking NSAIDs and anti‐ulcer drugs was obtained from all patients who underwent endoscopic examinations. The lesion scores of patients taking L‐A were classified numerically from zero (no lesion) to five (ulcer). Results : The NSAIDs were associated with 28.2% of hemorrhagic ulcers. The rates of patients using L‐A, loxoprofen, diclofenac, and combination of two of these drugs were 27, 16, 10 and 9%, respectively. Co‐administered anti‐ulcer drugs were cytoprotective anti‐ulcer drugs (27%), H2 receptor antagonists (16%), PPI (4%), and none (53%). In patients taking L‐A, H2 receptor antagonists were used most frequently. The HP was positive in 63% of L‐A‐induced ulcer cases and in 69% of NSAIDs other than low‐dose aspirin‐induced ulcer cases. The lesion scores of patients taking L‐A with H2 receptor antagonists or PPI were significantly lower than those of patients who were taking only L‐A ( P < 0.05). Conclusions : Approximately one‐third of hospitalized patients with NSAIDs‐induced hemorrhagic ulcer showed an association with L‐A. Prospective randomized controlled trials including H2 receptor antagonists are required to establish preventive efforts aimed at L‐A‐induced gastro‐duodenal injury.