title: A clinical study of Japanese patients with ulcer induced by low-dose aspirin and other non-steroidal anti-inflammatory drugs.
abstract: BACKGROUND
  The incidence and severity of non-steroidal anti-inflammatory drugs (NSAIDs)-induced gastro-duodenal ulcer have not been extensively studied in Japan.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Gastroenterology & Hepatology, Saitama Medical School, Iruma-gun, Saitama, Japan. sayaka-n@coffee.ocn.ne.jp
authors.forename: S
authors.initials: S
authors.lastname: Nakashima
authors.forename: S
authors.initials: S
authors.lastname: Arai
authors.forename: Y
authors.initials: Y
authors.lastname: Mizuno
authors.forename: K
authors.initials: K
authors.lastname: Yoshino
authors.forename: S
authors.initials: S
authors.lastname: Ando
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Sugawara
authors.forename: M
authors.initials: M
authors.lastname: Koike
authors.forename: E
authors.initials: E
authors.lastname: Saito
authors.forename: M
authors.initials: M
authors.lastname: Naito
authors.forename: M
authors.initials: M
authors.lastname: Nakao
authors.forename: H
authors.initials: H
authors.lastname: Ito
authors.forename: K
authors.initials: K
authors.lastname: Hamaoka
authors.forename: F
authors.initials: F
authors.lastname: Rai
authors.forename: Y
authors.initials: Y
authors.lastname: Asakura
authors.forename: M
authors.initials: M
authors.lastname: Akamatu
authors.forename: K
authors.initials: K
authors.lastname: Fujimori
authors.forename: M
authors.initials: M
authors.lastname: Inao
authors.forename: Y
authors.initials: Y
authors.lastname: Imai
authors.forename: S
authors.initials: S
authors.lastname: Ota
authors.forename: K
authors.initials: K
authors.lastname: Fujiwara
authors.forename: M
authors.initials: M
authors.lastname: Shiibashi
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D016558:Hemostasis, Endoscopic; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D001241:Aspirin