Proton-pump inhibitors, antisecretory drugs and nitrates reducegastrointestinal bleeding risk in patients taking NSAIDs – but PPIs aremost effective, say the authors of a large epidemiological study.Strategies suggested to address GI bleeding – a major risk in NSAIDtherapy – include COX-2 selective agents, misoprostol, antisecretoryagents and organic nitrates.
The study aimed to determinewhich agents effectively reduced risk of upper GI peptic ulcer bleedsassociated with nonselective NSAIDs, aspirin and other antiplateletagents, and anticoagulants. The 2001–2004 study involved prospectivecase determination and retrospective data collection and used data fromSpanish hospitals linked in a gastroenterology network.
Caseswere adults hospitalised with confirmed upper-GI peptic ulcer bleeding,with 2,777 patients matched with 5,532 controls (each case matched withtwo controls). Cases and controls were classified as having a historyof ulcer, dyspepsia, or neither. Current relevant drug use includedNSAID, antiplatelet drugs, anticoagulants, PPI, histamine-2 receptorantagonists and any nitrate.
Am J Gastroenterol 2007;102:507-15p