Non-steroidal anti-inflammatory drugs (NSAIDs) - including ibuprofen, diclofenac, naproxen and others - are commonly used pain medications that are generally safe but may increase the risk of developing stomach and intestinal ulcers.

After researchers analyzed a large number of clinical trials that compared different ways of reducing these risks of NSAIDs, they found that the best strategy with the lowest overall risk was to combine a certain type of NSAID, known as a COX-2-selective NSAID, with a proton pump inhibitor (PPI). PPIs are most often used to treat heartburn and gastro-oesophageal reflux disease.

"The combination of a COX-2-selective NSAID with a PPI will be expensive and is not recommended for all patients who need to be on a NSAID; however, it is the safest and most effective treatment strategy for those at high risk of ulcer bleeding from NSAID treatment," said Prof. Jin Ling Tang, co-author of the Alimentary Pharmacology and Therapeutics study.

Article: Systematic review with network meta-analysis: comparative effectiveness and safety of strategies for preventing NSAID-associated gastrointestinal toxicity, J.Q.Yuan, K. K. F.Tsoi ,M.Yang, J.Y.Wang, D. E.Threapleton, Z.Y.Yang, B. Zou, C.Mao, J. L.Tang, & F. K. L.Chan, doi :10.1111/apt.13642, published online 28 April 2016.