title: Comparison of proton pump inhibitor and histamine-2 receptor antagonist in the prevention of recurrent peptic ulcers/erosions in long-term low-dose aspirin users: a retrospective cohort study.
abstract: BACKGROUND
  Proton pump inhibitor and histamine-2 receptor antagonist can prevent aspirin-related ulcers/erosions but few studies compare the efficacy of these two agents. Aims. We evaluated the efficacy of omeprazole and famotidine in preventing recurrent ulcers/erosions in low-dose aspirin users.
  
  
  METHODS
  The 24-week clinical outcomes of the patients using low-dose aspirin for cardiovascular protection with a history of ulcers/erosions and cotherapy of omeprazole or famotidine were retrospectively reviewed. The incidence of gastrointestinal symptoms, recurrent ulcers/erosions, erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was analyzed.
  
  
  RESULTS
  A total of 104 patients (famotidine group, 49 patients; omeprazole group, 55 patients) were evaluated. Famotidine group had more gastrointestinal symptoms episodes than omeprazole group (46.9% versus 23.6%, P=0.01). Fifteen famotidine group patients and 5 omeprazole group patients had recurrent ulcers/erosions (30.6% versus 9.1%, P=0.005). Lanza scale was significantly lower in omeprazole group than in famotidine group (1.2±0.7 versus 1.7±1.1, P=0.008). Only 1 famotidine group patient had ulcer bleeding. The incidences of erosive esophagitis and thromboembolic events were comparable between both groups.
  
  
  CONCLUSIONS
  Omeprazole was superior to famotidine with less gastrointestinal symptoms and recurrent ulcers/erosions in patients using 24-week low-dose aspirin. The risk of erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was similar between both groups.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan ; School of Medicine, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan ; Department of Chemistry, College of Science, National Kaohsiung Normal University, No. 62, Shenjhong Road, Kaohsiung 824, Taiwan.
authors.forename: Wen-Chi
authors.identifier: 0000-0002-7572-4201
authors.initials: WC
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
authors.forename: Yun-Da
authors.initials: YD
authors.lastname: Li
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
authors.forename: Po-Hung
authors.initials: PH
authors.lastname: Chiang
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan ; Department of Sport, Health & Leisure, Cheng Shiu University, No. 840, Chengcing Road, Kaohsiung 833, Taiwan.
authors.forename: Feng-Woei
authors.initials: FW
authors.lastname: Tsay
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan ; School of Medicine, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan.
authors.forename: Hoi-Hung
authors.initials: HH
authors.lastname: Chan
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan ; School of Medicine, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan.
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Tsai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
authors.forename: Tzung-Jiun
authors.identifier: 0000-0002-8228-5104
authors.initials: TJ
authors.lastname: Tsai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
authors.forename: E-Ming
authors.initials: EM
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
authors.forename: Jin-Shiung
authors.initials: JS
authors.lastname: Cheng
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan ; School of Medicine, National Yang-Ming University, No. 155, Section 2, Linong Street, Taipei 112, Taiwan.
authors.forename: Kwok-Hung
authors.identifier: 0000-0002-3085-6534
authors.initials: KH
authors.lastname: Lai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000473:pathology; D015738:Famotidine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006635:Histamine H2 Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000009:adverse effects; D010437:Peptic Ulcer / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013923:Thromboembolism / Q000139:chemically induced / Q000473:pathology
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D015738:Famotidine; D009853:Omeprazole; D001241:Aspirin