[Effectiveness, safety, and costs of measures for prevention of gastropathy due to the use of nonsteroidal antiinflammatory drugs].
NSAID gastropathy, because of its severity and prevalence, is the most important side effect of nonsteroidal anti-inflammatory drugs. Protective strategies are advocated in patients with high risk for NSAID gastropathy (age over 60 years and/or previous ulcer). Different strategies for the prevention of NSAID gastropathy are: using a cyclo-oxygenase (COX)-2 inhibitor, adding a prostaglandin analogue, an H2-receptor antagonist or a proton pump inhibitor or eradicating Helicobacter pylori. On the basis of efficacy, safety and costs prescription of a proton pump inhibitor as a prophylactic agent appears to be the best option; prescription of a prostaglandin analogue is a good alternative. The preliminary data on the COX-2 inhibitors are promising. The role of H. pylori in NSAID gastropathy is not yet elucidated.
Steen
K S
KS
Academisch Ziekenhuis Vrije Universiteit, afd. Reumatologie, Amsterdam.
Lems
W F
WF
Dijkmans
B A
BA
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000517:prevention & control; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D011448:Prostaglandin Antagonists / Q000627:therapeutic use; D013272:Stomach Diseases / Q000139:chemically induced* / Q000382:microbiology / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D016861:Cyclooxygenase Inhibitors; D006635:Histamine H2 Antagonists; D011448:Prostaglandin Antagonists