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Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly used drugs
in the Western world. Patients undergoing NSAID therapy often experience abdominal
discomfort, and some of them develop serious complications, such as ulceration, perforation,
or bleeding. Since serious complications of NSAID therapy can occur in relatively
asymptomatic patients and abdominal symptoms do not serve as a signal of impending
difficulties, there is a need for methods to identify those patients who may benefit
from prophylactic therapy to prevent NSAID-induced injury.
Therapy to prevent NSAID-associated gastrointestinal ulcerations is most effective
when prostaglandins are used. H2-receptor antagonists prevent duodenal ulcerations but not gastric ulcerations. The
role of omeprazole (hydrogen-potassium pump inhibitor) and sucralfate in the prevention
of gastroduodenal ulcerations has not been firmly established.
Healing of existing ulcerations in the face of continuing therapy with NSAIDs is marginally
accelerated by H2-receptor antagonists, but the rate of healing in the presence of continued NSAID
therapy is much slower than when NSAIDs are discontinued. Omeprazole may prove to
accelerate the healing of NSAID-associated ulcerations even when NSAID therapy is
continued, but more information is needed to substantiate this possibility.
New methods are needed for early noninvasive detection of mucosal damage by NSAIDs
and for the identification of individuals who should receive prophylactic therapy.
New agents are also needed to provide cost-effective prophylaxis against the development
of ulcerations and serious complications from NSAIDs.
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Article Info
Publication History
Accepted:
May 18,
1993
Received:
January 25,
1993
Identification
Copyright
© 1994 Published by Elsevier Inc.
