[Risks of severe digestive adverse effects of NSAIDs. Evaluation methods of mucoprotective drugs].
Frequency and severity of digestive adverse events due to NSAIDs are not similarly estimated by rheumatologists and gastroenterologists. A recent meta-analysis showed that NSAIDs users were at approximately three times greater relative risk for developing serious adverse gastrointestinal events than nonusers. Additional risk factors included age greater than 60 years, previous history of gastrointestinal events and concomitant corticosteroid use. Serious adverse gastrointestinal events are rare and preventive treatments cannot be evaluated with prospective trials. Therefore, the model of acute lesions induced by a 7 days treatment with NSAIDs is used. Most of patients given NSAIDs for a few days have gastric lesions (erosions or submucosal hemorrhage) which do not cause symptoms and spontaneously disappear despite the treatment continues. Evaluation of severity of lesions at day 7 after starting treatment proved to be adequate to compare gastrotoxicity of different NSAIDs and to assess efficiency of gastroprotection drugs. This model is appropriate to evaluate the protective effect of diacerheine.
Delchier
J C
JC
Service d'Hépathologie et de Gastroentérologie, Hôpital Henri Mondor, Créteil.
Belda
E
E
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004066:Digestive System Diseases / Q000139:chemically induced* / Q000517:prevention & control; D005753:Gastric Mucosa / Q000187:drug effects; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects; D011358:Product Surveillance, Postmarketing
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents
Risques d'effets indésirables digestifs graves dus aux AINS. Méthodes d'évaluation des médicaments mucoprotecteurs.