title: How do we manage serious gastrointestinal adverse events associated with anti-thrombotic therapy?
abstract: Antithrombotic therapy (ATTs) is increasingly used worldwide for preventing primary or recurrent thrombotic events. Moreover, newer oral anti-platelet drugs and anti-coagulants have been introduced for clinical use, accelerating the number of patients under ATT. Not infrequently, these drugs are used in combination. These drugs, however, are well-known for adverse events in which gastrointestinal bleeding (GIB) is most common. Bleeding during ATT can be fatal, but even when patients survive, their prognosis is rather poor. Therefore, it is imperative to minimize such events. So far, co-prescription of proton pump inhibitor (PPI) has been documented to be the most effective in reducing upper GI injury and bleeding, though deliberate use of PPIs is required to minimize drug interaction and associated adverse events with acid suppression. In addition, we should note that PPI is not effective in preventing mid- or lower-GI injury/bleeding for which only limited evidence on preventive measures is available.
authors.affiliation: Department of Medicine, Jichi Medical University, 3311-1 Shimotsuke, Tochigi 329-0498, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors
keywords: anti-coagulants; anti-platelet drugs; anti-thrombotic therapy; gastrointestinal bleeding; gastrointestinal ulcer; proton pump inhibitor