Usefulness of anti-ulcer drugs for the prevention and treatment of peptic ulcers induced by low doses of aspirin.
OBJECTIVE
To investigate the usefulness of anti-ulcer drugs for the prevention and treatment of low-dose aspirin-induced peptic ulcer.


METHODS
Upper gastrointestinal endoscopy was performed in 68 patients receiving daily low-dose aspirin (81 or 100 mg/day). The endoscopic findings were classified according to the Lanza score, and the scores were compared between groups categorized according to the concomitant use of anti-ulcer drugs and the types of drugs used. In another study, 31 hemorrhagic peptic ulcer patients who had been receiving low-dose aspirin were enrolled. The patients were randomly classified into the proton pump inhibitor (PPI)-treated group and the H2 receptor antagonist (H2RA)-treated group. The administration of low-dose aspirin was continued concomitantly, and endoscopic examinations were performed 8 wk later.


RESULTS
The Lanza scores (mean +/- SD) of the gastro-mucosal lesions were 1.0 +/- 1.9 and 1.9 +/- 2.3 in 8 and 16 patients receiving prevention therapy with a PPI and an H2RA, respectively. Both scores were significantly smaller than the scores in 34 patients who were not receiving prevention therapy (4.7 +/- 1.0) and in 10 patients receiving cytoprotective anti-ulcer drugs (4.3 +/- 1.6). In the prospective study, 18 and 13 patients received a PPI and an H2RA, respectively. Endoscopic examinations revealed that the tissue in the region of the gastro-mucosal lesions had reverted to normal in all patients in the PPI-treated group and in 12 patients (92%) in the H2RA-treated group; no significant differences were observed between the groups.


CONCLUSIONS
H2RA therapy was effective for both the prevention and treatment of low-dose aspirin-induced peptic ulcer, similar to the effects of PPIs, while cytoprotective anti-ulcer drugs were ineffective in preventing ulceration.
Nakashima
Sayaka
S
Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-cho, Iruma-gun, Saitama 350-0495, Japan.
Ota
Shinichi
S
Arai
Shin
S
Yoshino
Kiyoko
K
Inao
Mie
M
Ishikawa
Keiko
K
Nakayama
Nobuaki
N
Imai
Yukinori
Y
Nagoshi
Sumiko
S
Mochida
Satoshi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000473:pathology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin