Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract

Best Practice and Research: Clinical Gastroenterology

Volumn 24, Issue 2, 2010, Pages 121-132

  Sostres, Carlos ^a   Gargallo, Carla J ^a   Arroyo, Maria T ^a,b   Lanas, Angel ^a,b,c  

^a HOSPITAL CLÍNICO UNIVERSITARIO LOZANO BLESA   (Spain)

^b INSTITUTO DE SALUD CARLOS III   (Spain)

^c UNIVERSITY OF ZARAGOZA   (Spain)

Author keywords

coxibs; GI damage; NSAIDs; proton pump inhibitors

Indexed keywords

ACECLOFENAC; ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ASPIRIN PLUS CLOPIDOGREL; CELECOXIB; CLOPIDOGREL; CYCLOOXYGENASE 2 INHIBITOR; DICLOFENAC; ESOMEPRAZOLE; ETORICOXIB; FAMOTIDINE; HISTAMINE H2 RECEPTOR ANTAGONIST; IBUPROFEN; LANSOPRAZOLE; LUMIRACOXIB; MISOPROSTOL; NAPROXEN; NONSTEROID ANTIINFLAMMATORY AGENT; OMEPRAZOLE; PLACEBO; PROTON PUMP INHIBITOR; RANITIDINE; ROFECOXIB; UNCLASSIFIED DRUG;

ABDOMINAL PAIN; ACUTE CORONARY SYNDROME; AGE; ARTICLE; BLOOD PRESSURE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR SYMPTOM; CLINICAL TRIAL; COST EFFECTIVENESS ANALYSIS; DIARRHEA; DIGESTIVE SYSTEM INJURY; DRUG ACTIVITY; DRUG BINDING; DRUG CONTRAINDICATION; DRUG EFFICACY; DRUG FATALITY; DRUG INDUCED DISEASE; DRUG MEGADOSE; DRUG SAFETY; DRUG TRANSPORT; DRUG TREATMENT FAILURE; DRUG WITHDRAWAL; DUODENUM ULCER; DYSPEPSIA; ERADICATION THERAPY; GASTRIC ULCER BLEEDING; GASTRODUODENAL ULCER; GASTROINTESTINAL HEMORRHAGE; GASTROINTESTINAL SYMPTOM; HELICOBACTER PYLORI; HIP FRACTURE; HUMAN; INTESTINE INFECTION; KIDNEY FUNCTION; LOW DRUG DOSE; NONHUMAN; OSTEOARTHRITIS; PATIENT COMPLIANCE; PEPTIC ULCER; PEPTIC ULCER BLEEDING; PNEUMONIA; RECURRENT DISEASE; RECURRENT PEPTIC ULCER; RHEUMATOID ARTHRITIS; RISK ASSESSMENT; RISK FACTOR; SIDE EFFECT; STOMACH EROSION; STOMACH MUCOSA LESION; STOMACH ULCER; UPPER GASTROINTESTINAL TRACT;

ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; ASPIRIN; CYCLOOXYGENASE 2 INHIBITORS; CYTOPROTECTION; GASTRIC MUCOSA; GASTROINTESTINAL DISEASES; GASTROINTESTINAL TRACT; HUMANS; PATIENT SELECTION; RISK ASSESSMENT; RISK FACTORS;

EID: 77749343038     PISSN: 15216918     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.bpg.2009.11.005     Document Type: Article

References (85)

1. Jones R. Nonsteroidal anti-inflammatory drug prescribing: past, present, and future. Am J Med 110 (2001) 4S-7S
2. Shaheen N.J., Hansen R.A., Morgan D.R., Gangarosa L.M., Ringel Y., Thiny M.T., et al. The burden of gastrointestinal and liver diseases, 2006. Am J Gastroenterol 101 (2006) 2128-2138
3. Schoen R.T., and Vender R.J. Mechanisms of nonsteroidal anti-inflammatory drug-induced gastric damage. Am J Med 86 (1989) 449-458
4. Scheiman J.M. NSAIDs, gastrointestinal injury, and cytoprotection. Gastroenterol Clin North Am 25 (1996) 279-298
5. Lanas A., and Scheiman J. Low-dose aspirin and upper gastrointestinal damage: epidemiology, prevention and treatment. Curr Med Res Opin 23 (2007) 163-173
6. Konturek S.J., Konturek P.C., and Brzozowski T. Prostaglandins and ulcer healing. J Physiol Pharmacol 56 Suppl. 5 (2005 Sept) 5-31 Review
7. Wallace J.L., McKnight W., Reuter B.K., and Vergnolle N. NSAID-induced gastric damage in rats: requirement for inhibition of both cyclooxygenase 1 and 2. Gastroenterology 119 (2000) 706-714
8. Lanas A., García Rodriguez L.A., Polo-Tomas M., Ponce M., Alonso-Abreu I., Perez Aisa M.A., et al. Time trends and impact of upper and lower gastrointestinal bleeding and perforation in clinical practice. Am J Gastroenterol 104 7 (2009 Jul) 1633-1641
9. Brun J., and Jones R. Non-steroidal anti-inflammatory drug-associated dyspepsia: the scale of the problem. Am J Med 110 (2001) 12S-13S
10. Armstrong C.P., and Blower A.L. Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration. Gut 28 (1987) 527-532
11. Larkai E.N., Smith J.L., Lidsky M.D., and Graham D.Y. Gastroduodenal mucosa and dyspeptic symptoms in arthritic patients during chronic steroidal anti-inflammatory drug use. Am J Gastroenterol 82 (1987) 1153-1158
12. Lanas A., and Hunt R. Prevention of anti-inflammatory drug induced gastrointestinal damage: benefits and risks of therapeutic strategies. Ann Med 38 (2006) 415-428
13. Silverstein F.E., Graham D.Y., Senior J.R., Davies H.W., Sttruthers B.J., Bittman R.M., et al. Misoprostol reduces serious gastrointestinal complications in patients with rheumatoid arthritis receiving nonsteroidal anti-inflammatory drugs. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 123 (1995) 241-249
14. Bombardier C., Laine L., Reicin A., Shapiro D., Burgos-Vargas R., Davis B., et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 343 (2000) 1520-1528
15. Silverstein F.E., Faich G., Goldstein J.L., Simon L.S., Pincus T., Whelton A., et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. J Am Med Assoc 284 (2000) 1247-1255
16. Schnitzer T.J., Burmester G.R., Mysler E., Hochberg M.C., Doherty M., Ehrsam E., et al. Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), reduction in ulcer complications: randomised controlled trial. Lancet 364 (2004) 665-674
17. Tannenbaum H., Bombardier C., Davis P., Russell A.S., and Third Canadian Consensus Conference Group. An evidence based approach to prescribing nonsteroidal antiinflammatory drugs. Third Canadian Consensus Conference. J Rheumatol 33 (2006) 140-157 Erratum in: J Rheumatol. 2006;33:829 and J Rheumatol. 2006;33:440
18. De Abajo F.J., and García Rodríguez L.A. Risk of upper gastrointestinal bleeding and perforation associated with low-dose aspirin as plain and enteric-coated formulations. BMC Clin Pharmacol 1 (2001) 1
19. Lanas A., García Rodriguez L.-A., Arroyo M.T., Gomollon F., Feu F., Gonzalez-Pérez A., et al. Risk of upper gastrointestinal ulcer bleeding associated with selective COX-2 inhibitors, traditional non-aspirin NSAIDs, aspirin, and combinations. Gut 55 12 (2006 Dec) 1731-1738
20. Ramsoekh D., Van Leerdam M.E., Rauws E.A.J., and Tygat G.N. Outcome of peptic ulcer bleeding, nonsteroidal anti-inflammatory drug use and Helicobacter pylori infection. Clin Gastroenterol Hepatol 3 (2005) 859-864
21. Lanas A., Perez-Aisa M.A., Feu F., Ponce J., Saperas E., Santolaria S., et al., Investigators of the Association Espanola de Gastroenterologia (AEG). A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal anti-inflammatory drug use. Am J Gastroenterol 100 (2005) 1685-1693
22. Singh G., and Ramey D.R. NSAID induced gastrointestinal complications: the ARAMIS perspective. J Rheumatol 25 (1998) 8-16
23. Fries J.F., Murtagh K.N., Bennett M., Zatarain E., Lingala B., Bruce B., et al. The rise and decline of nonsteroidal antiinflammatory drug-associated gastropathy in rheumatoid arthritis. Arthritis Rheum 50 8 (2004) 2433-2440
24. Pérez-Aisa M.A., Del Pino D., Siles M., and Lanas A. Clinical trends in ulcer diagnosis in a population with high prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther 21 (2005) 65-67
25. Sonnenberg A. Time trends of ulcer mortality in non-European countries. Am J Gastroenterol 102 (2007) 1101-1107
26. Hermansson M., Ekedahl A., Ranstam J., and Zilling T. Decreasing incidence of peptic ulcer complications after de introduction of the proton pump inhibitors, a study of the Swedish population from 1974-2002. BMC Gastroenterol 9 (2009 Apr 20) 25
27. Sung J., Kuipers E., and El-Serag H. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther 29 9 (2009 May 1) 938-946
28. Post P.N., Kuipers E.J., and Meijer G.A. Declining incidence of peptic ulcer but not of its complications: a nation-wide study in the Netherland. Aliment Pharmacol Ther 23 (2006) 1587-1593
29. Kang J.Y., Elders A., Majeed A., Maxwell J.D., and Bardhan K.D. Recent trends in hospital admissions and mortality rates for peptic ulcer in Scotland 1982-2002. Aliment Pharmacol Ther 24 (2006) 65-79
30. Zhao Y, Encinosa W. Hospitalizations for gastrointestinal bleeding in 1998 and 2006. Healthcare cost and utilization project. 2008 Dec.
31. Moore R.A., Derry S., Makinson G.T., and McQuay H.J. Tolerability and adverse events in clinical trials of celecoxib in osteoarthritis and rheumatoid arthritis: systematic review and meta-analysis of information from company clinical trial reports. Arthritis Res Ther 7 (2005) R644-R665
32. Singh G., Fort J.G., Goldstein J.L., Levy R.A., Hanrahan P.S., Bello A.E., et al. Celecoxib versus naproxen and diclofenac in osteoarthritis patients: SUCCESS-I Study. Am J Med 119 (2006) 255-266
33. Skelly M.M., and Hawkey C.J. Dual COX inhibition and upper gastrointestinal damage. Curr Pharm Des 9 (2003) 2191-2195
34. Laine L., Maller E.S., Yu C., Quan H., and Simon T. Ulcer formation with low-dose enteric-coated aspirin and the effect of COX-2 selective inhibition: a double-blind trial. Gastroenterology 127 (2004) 395-402
35. Rahme E., Dasgupta K., Toubouti Y., Barkoun A.N., and Bardou M. GI effect of rofecoxib and celecoxib versus NSAID in patients on low dose aspirin, a population-based retrospective cohort study. Gastroenterology (2004) 126
36. Lanas A., Garcia-Rodriguez L.A., Arroyo M.A., Gomollón F., Zapata E., Bujanda L., et al. Coxibs, NSAIDs, aspirin, PPIs and the risks of upper GI bleeding in common clinical practice. Gastroenterology 128 (2005) 629
37. Bresalier R.S., Sandler R.S., Quan H., Bolognese J.A., Oxenius B., Horgan K., et al. Adenomatous polyp prevention on Vioxx (APPROVe) trial investigators. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352 11 (2005) 1092-1102
38. Solomon S.D., Mc Murray J.J., Pfeffer M.A., Wittes J., Fowler R., Finn P., et al. Adenoma Prevention with Celecoxib (APC) study Investigators. Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med 352 11 (2005 Mar 17) 1071-1080
39. Rostom A., Muir K., Dube C., Lanas A., Jolicoeur E., and Tugwell P. Prevention of NSAID-related upper gastrointestinal toxicity: a meta-analysis of traditional NSAIDs with gastroprotection and COX-2 inhibitors. Drug Health Care Pat Saf 1 (2009) 1-25
40. Arber N., Eagle C.J., Spicak J., Rácz I., Dite P., Hajer J., et al. Pre-SAP Trial Investigators. Celecoxib for de prevention of colorectal adenomatous polyps. N Engl J Med 355 9 (2006 Aug 31) 885-895
41. McHippisley-Cox J., and Coupland C. Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ 330 7504 (2005) 1366
42. Chan A.T., Manson J.E., Albert C.M., Chae C.U., Rexrode K.M., Curhan G.C., et al. Nonsteroidal antiinflammatory drugs, acetaminophen, and the risk of cardiovascular events. Circulation (2006 Mar 13)
43. Mc Gettigan P., and Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and non selective inhibitors of cyclooxygenase 2. J Am Med Assoc 296 13 (2006 Oct 4) 1633-1644
44. Cannon C.P., Curtis S.P., FitzGerald G.A., Krum H., Kaur A., Bolognese J.A., et al. MEDAL Steering Committee. Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: A randomized comparison. Lancet 368 9549 (2006 Nov 18) 1771-1781
45. Laine L., Curtis S.P., Cryer B., Kaur A., and Cannon C.P. MEDAL Steering Committee. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: A randomized comparison. Lancet 369 9560 (2007 Feb 10) 465-473
46. Lanas A. Role of nitric oxide in the gastrointestinal tract. Arthritis Res Ther 10 Suppl. 2 (2008) S4
47. Mackenzie I.S., Rutherford D., and MacDonald T.M. Nitric oxide and cardiovascular effects: new insights in the role of nitric oxide for the management of osteoarthritis. Arthritis Res Ther 10 Suppl. 2 (2008) S3
48. Hawkey C.J., Jones J.I., Atherton C.T., Skelly M.M., Bebb J.R., Fagerholm U., et al. Gastrointestinal safety of AZD3582, a cyclooxygenase inhibiting nitric oxide donator: proof of concept study in humans. Gut 52 11 (2003 Nov) 1537-1542
49. White W.B., Schnitzer T.J., Fleming R., Duquesroix B., and Beekman M. Effects of the cyclooxygenase inhibiting nitric oxide donator naproxcinod versus naproxen on systemic blood pressure in patients with osteoarthritis. Am J Cardiol 104 6 (2009 Sep 15) 840-845
50. Lanas A., Fuentes J., Benito R., Bajador E., Serrano P., and Sainz R. Helicobacter pylori increases the risk of gastrointestinal bleeding in patients taking low dose aspirin. Gastroenterology 118 (2000) A252
51. Laine L., Bombardier C., Hawkey C.J., Davis B., Shapiro D., Brett C., et al. Sratifying the risk of NSAID-related upper gastrointestinal clinical events: results of a double-blind outcomes study in patients with rheumatoid arthritis. Gastroenterology 123 4 (2002 Oct) 1006-1012
52. Langman M.J., Weil J., Wainwright P., Lawson D.H., Rawlins M.D., Logan R.F., et al. Risks of bleeding peptic ulcer associated with individual non-steroidal anti-inflammatory drugs. Lancet 343 (1994 Apr 30) 1075-1078
53. Huang J.Q., Sridhar L., and Hunt R.H. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet 359 (2002) 14-22
54. Chan F.K., Chung S.C., Suen B.Y., Lee Y.T., Leung W.K., Leung V.K., et al. Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. N Engl J Med 344 (2001) 967-973
55. Abraham N.S., Hartman C., Castillo D., Richardson P., and Smalley W. Effectiveness of national provider prescription of PPI gastroprotection among elderly NSAID users. Am J Gastroenterol 103 (2008) 323-332
56. Johnson D.A. Upper GI risks of NSAIDs and antiplatelet agents: key issues for the cardiologist. Rev Cardiovasc Med 6 Suppl. 4 (2005) S15-S22
57. Rostom A., Dube C., Wells G., Tugwell P., Welch V., Jolicoeur E., et al. Prevention of NSAID-induced gastroduodenal ulcers. Cochrane Database Syst Rev 4 (2002) 1-111 (CD002296)
58. Hooper L., Brown T.J., Elliott R., Payne K., Roberts C., and Symmons D. The effectiveness of five strategies for the prevention of gastrointestinal toxicity induced by non-steroidal anti-inflammatory drugs: systematic review. BMJ 329 7472 (2004) 948-957
59. Taha A.S., McCloskey C., Prasad R., and Bezlyak V. Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): A phase III, randomised, double-blind, placebo-controlled trial. Lancet 374 9684 (2009 Jul 11) 119-125
60. Canadian Coordinating Office for Health Technology Assessment. Gastroduodenal ulcers associated with the use of non-steroidal anti-inflammatory drugs: a systematic review of preventive pharmacological interventions (2004 Feb), Canadian Coordinating Office for Health Technology Assessment, Ottawa Report No.: 12
61. Graham D.Y., Agrawal N.M., Campbell D.R., Haber M.M., Collis C., Lukasik N.L., et al. NSAID-Associated Gastric Ulcer Prevention Study Group. Ulcer prevention in long-term users of nonsteroidal anti-inflammatory drugs: results of a double-blind, randomized, multicenter, active- and placebo-controlled study of misoprostol vs lansoprazole. Arch Intern Med 162 2 (2002 Jan 28) 169-175
62. Lai K.C., Lam S.K., Chu K.M., Wong B.C., Hui W.M., Hu W.H., et al. Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. N Engl J Med 346 26 (2002 Jun 27) 2033-2038
63. Chan F., Ching J.Y., Hung L.C., Wong V.W., Leung V.K., Kung N.M., et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 352 3 (2005 Jan 20) 238-244
64. Lanas A., García-Rodriguez L.A., Arroyo M.T., Bujanda L., Gomollon F., Forné M., et al. Effect of antisecretory drugs and nitrates on the risk of ulcer bleeding associated with nonsteroidal anti-inflammatory drugs, antiplatelet agents, and anticoagulants. Am J Gastroenterol 102 3 (2007 Mar) 507-515
65. Laheij R.J., Sturkenboom M.C., Hassing R.J., Dieleman J., Stricker B.H., and Jansen J.B. Risk of community-acquired pneumonia and use of gastric acid-suppressive drugs. J Am Med Assoc 292 16 (2004 Oct 27) 1955-1960
66. Ho P.M., Maddox T., Wang l., Finhn S.D., Jesse R.L., Peterson E.D., et al. Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome. J Am Med Assoc 301 9 (2009) 937-944
67. Laine L. Proton pump inhibitors and bone fractures?. Am J Gastroenterol 104 2 Suppl. (2009 Mar) S21-S26
68. Hunt R.H., Harper S., Callegari P., Yu C., Quan H., Evans J., et al. Complementary studies of the gastrointestinal safety of the cyclo-oxygenase-2-selective inhibitor etoricoxib. Aliment Pharmacol Ther 17 2 (2003 Jan) 201-210
69. Chan F.K., Hung L.C., et al. Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis. N Engl J Med 347 26 (2002 Dec 26) 2104-2110
70. Lai K.C., Chu K.M., Hui W.M., Wong B.C., Hu W.H., Wong W.M., et al. Celecoxib compared with lansoprazole and naproxen to prevent gastrointestinal ulcer complications. Am J Med 118 11 (2005) 1271-1278
71. Lanas A., Martin-Mola E., Ponce J., Navarro F., Pique J.M., and Blanco F.J. Clinical strategy to prevent the gastrointestinal adverse effects of nonsteroidal anti-inflammatory agents. Gastroenterol Hepatol 26 8 (2003) 485-502
72. Lanas A. Economic analysis of strategies in the prevention of non-steroidal anti-inflammatory drug-induced complications in the gastrointestinal tract. Aliment Pharmacol Ther 20 3 (2004) 321-331
73. Chan F.K.L., Wong V.W., Suen B.Y., Wu J.C., Leung W.H., Le Y.T., et al. Proton pump inhibitor plus a COX-2 selective inhibitors for the prevention of recurrent ulcer bleeding in patients with arthritis. A double blind, randomized trial. Gastroenterology 130 (2006) 133 (A732)
74. Latimer N., Lord J., Grant R.L., O'Mahony R., Dickson J., Conaghan P.G., et al. Cost effectiveness of COX-2 selective inhibitors and traditional NSAIDs or in combination with a proton pump inhibitor for people with osteoarthritis. BMJ 339 (2009 Jul 14) b2538
75. Sturkenboom M.C.J.M., Burke T.A., Tangelder M.J.D., et al. Adherence to proton pump of inhibitors or H2-receptor antagonists during the use of non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther 18 (2003) 1137-1147
76. Van Soest E., Sturkenboom M.C.J.M., Dieleman J.P., et al. Adherence to gastroprotection and the risk of NSAID-related upper gastrointestinal ulcers and haemorrhage. Aliment Pharmacol Ther 26 2 (2007 Jul 15) 265-275
77. Abraham N.S., El-Serag H.B., Johnson M.L., Hartman C., Richardson P., Ray W.A., et al. National adherence to evidence-based guidelines for the prescription of non-steroidal anti-inflammatory drugs. Gastroenterology 126 (2005) 1171-1178
78. Chan F.K., To K.F., Wu J.C., Yung M.Y., Leung W.K., Kwok T., et al. Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomised trial. Lancet 5 359 (2002) 9-13
79. Hawkey C.J., Tulassay Z., Szczepanski L., Van Rensburg C.J., Filipowicz-Sosnowska A., Lanas A., et al. Randomised controlled trial of Helicobacter pylori eradication in patients on non-steroidal anti-inflammatory drugs: HELP NSAIDs study. [see comments] [published erratum appears in Lancet 1998;352:1634]. Lancet 352 (1998) 1016-1021 Comment in: Lancet 1998;352:1001-3
80. Hawkey C., Talley N.J., Yeomans N.D., Jones R., Sung J.J., Langstrom G., et al., NASA1 SPACE1 Study Group. Improvements with esomeprazole in patients with upper gastrointestinal symptoms taking non-steroidal antiinflammatory drugs, including selective COX-2 inhibitors. Am J Gastroenterol 100 5 (2005) 1028-1036
81. Yeomans N.D., Lanas A., Talley N.J., Thomson A.B., Daneshjoo R., Eriksson B., et al. Prevalence and incidence of gastroduodenal ulcers during treatment with vascular protective doses of aspirin. Aliment Pharmacol Ther 22 9 (2005) 795-801
82. Yeomans N.D., Tulassay Z., Juhasz L., Racz I., Howard J.M., van Rensburg C.J., et al. A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs. Acid suppression trial: ranitidine versus omeprazole for NSAID-associated Ulcer Treatment (ASTRONAUT) Study Group. N Engl J Med 338 11 (1998 Mar 12) 719-726
83. Cullen D., Bardhan K.D., Eisner M., Kogut D.G., Peacock R.A., Thomson J.M., et al. Primary gastroduodenal prophylaxis with omeprazole for non-steroidal anti-inflammatory drug users. Aliment Pharmacol Ther 12 (1998) 135-140
84. Lai K., Hui W., Wong B., Hu W., Chan O., and Lam S. Lansoprazole but not rofecoxib reduced dyspeptic symptoms of patients on NSAIDS. Gastroenterology 128 (2005) 137A
85. Lanas A. Review article: recommendations for the clinical management of patients taking non-steroidal anti-inflammatory drugs: a gastroenterologist's perspective. Aliment Pharmacol Ther 1 (2005) 16-19