[Factors affecting efficacy of proton pump inhibitors in NAID-induced gastric ulcers].
OBJECTIVE
To determine factors which may influence efficacy of therapy with proton pump inhibitors (PPI) in gastric ulcer (GU) induced by nonsteroid anti-inflammatory drugs (NAID).


METHODS
Two groups of GU patients treated with PPI in 2001-2005 were identified: 41 cases when ulcer healing was not achieved for 3 weeks and more (study group) and 218 cases treated for this time successfully (controls). The groups did not differ significantly by gender (females 84.6 and 78.6%) and age (59.2 +/- 16.8 and 58.7 +/- 12.4 years).


RESULTS
The patients of the study group had ulcers of 10 mm and more in size much more frequently than the controls (OR 12.5, CI 5.8-26). Also, rheumatoid arthritis (RA), ulcer history, intake of glucocorticosteroids, cytotoxic drugs, ineffective preventive treatment with PPI (OR 5.3, CI 3.4-8.4; OR 3.1, CI 1.5-6.0; OR 3.1, CI 1.6-6.0; OR 3.4, CI 1.7-6.7; OR 2.7, CI 1.3-5.6, respectively) were recorded in the study group more often. Helicobacter pylori was absent in 75.6% patients of the study group but these findings can not be compared with those in the controls as the majority of them had not been examined for gastric H. pylori.


CONCLUSIONS
Large ulcer, RA, ulcer history, treatment with GCS, cytotoxic drugs, PPI and, probably, the absence of H. pylori decrease efficacy of PPI in gastric ulcer induced by NAID.
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Karateev
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Diukov
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors; D013276:Stomach Ulcer / Q000139:chemically induced / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D009853:Omeprazole