[Treatment and prevention of gastrointestinal complications caused by non-steroidal antiphlogistic agents].

Abstract

The aim of our study is to give a survey of the most efficient methods for treatment and prevention of non-steroidal anti-inflammatory drug (NSAID)-induced gastrointestinal adverse in cases when antiphlogistic treatment cannot be discontinued due to active and progressive joint disease. Analysis of published studies shows that, the proton pump inhibitors (omeprazole) are the most efficient agents in treatment of gastric and duodenal ulcers induced by NSAIDs. The analysis shows a reliable effect of prostaglandin analogues (misoprostol) as well. Prostaglandin analogues (misoprostol) proved the most effective in treatment of gastric erosions. Prophylaxis of adverse gastrointestinal mucosal abnormalities can be primary or secondary. Secondary prevention is intended for patients with gastrointestinal symptoms or those treated for mucosal defects (ulcer, erosions). The standard prevention using H2-antagonists or sucralphate does not provide sufficient protection against NSAID in these patients, but omeprazole reduces the chance of a peptic lesion relapse. Primary prevention is intended for patients with a higher risk of gastrointestinal complications (age above 60, history of peptic ulcer, a higher dose of NSAID, simultaneous treatment with glucocorticoids or anticoagulants). Diclofenac with misoprostol and nabumetone reduce the incidence of gastroduodenal ulcers and their complications in short-term as well long-term studies. Meloxicam reduces the incidence of gastroduodenal mucosal abnormalities is short-term studies. Nimesulide is associated with a lower incidence of adverse gastrointestinal events, but the fact is that, reliable data on gastroduodenal ulcer incidence reduction or their complications are not available.

• Authors: I Rybár, M Kriska, A Vavrecka, R Hyrdel, J Rovenský
• Journal: Casopis lekaru ceskych (Cas Lek Cesk) Vol. 138 Issue 22 Pg. 675-80 (Nov 15 1999) ISSN: 0008-7335 [Print] Czech Republic
• Vernacular Title: Liecba a prevencia gastrointestinálnych komplikácií vyvolaných nesteroidovými antiflogistikami.
• PMID: 10746025 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Humans
• Peptic Ulcer (chemically induced, drug therapy, prevention & control)
• Risk Factors