Drug Cuts NSAID Users' Risk Of Hospitalization For Peptic Ulcer By More Than Half

Main Category: GastroIntestinal / Gastroenterology
Also Included In: Acid Reflux/GERD
Article Date: 02 Sep 2007 - 15:00 PDT

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People who also take a drug called a 'proton pump inhibitor" to reduce stomach acid when regularly using aspirin, ibuprofen, or another traditional non-steroidal anti-inflammatory drug (NSAID) for pain relief from arthritis or other conditions, cut their odds of eventually being hospitalized for an ulcer by 54 percent, according to a new study sponsored by HHS' Agency for Healthcare Research and Quality.

Researchers with the AHRQ-supported Vanderbilt University Center for Education and Research on Therapeutics led by Wayne A. Ray, Ph.D., analyzed the ulcer-related hospitalization rates of Medicaid patients who used either a traditional non-steroidal NSAID alone, or a coxib-2 drug with or without gastroprotective therapy -- a strategy for preventing NSAID-induced ulcers in patients - between 1996 and 2004.

Coxib-2 drugs are a newer type of NSAID that minimize the gastrointestinal adverse effects of the traditional drugs. Gastroprotective therapy counteracts the corrosive effects of stomach acid that can be caused by regular use of traditional NSAIDs and may involve the use of drugs such as protein pump inhibitors, misoprostol, or a double-dose histamine-2 receptor antagonist.

At any given time, an estimated 4 million Americans have peptic ulcer - a sore in the lining of the stomach or first part of the small intestine (duodendum). Most cases of peptic ulcer are caused by the stomach bacterium Helicobacter pylori, but NSAIDs can worsen existing sores or cause new ones.

The researchers found that proton pump inhibitors lowered ulcer hospitalization risks in users of traditional NSAIDs similarly to the 50 percent reduction achieved when the newer coxibs were prescribed with a proton pump inhibitor.

When the researchers looked at all types of gastroprotective therapy, they found that patients who currently took a coxib drug without the therapy had a 40 percent reduction in their risk of peptic ulcer hospitalization. Patients who took a traditional NSAID in conjunction with any type of gastroprotective reduced their risk of ulcer hospitalization by 39 percent.

For further findings, see "Risk of Peptic Ulcer Hospitalizations in Users of NSAIDs with Gastroprotective Cotherapy versus Coxibs," in the September, 2007 issue of Gastroenterology.

http://www.ahrq.gov