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NSAIDs-induced gastrointestinal damage. Review.
Minerva Gastroenterologica E Dietologica
|September 15, 2006
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) increase gastrointestinal risks. Balancing risks and using gastroprotective therapies like proton pump inhibitors (PPIs) is crucial for safe NSAID use, especially in high-risk patients.
Area of Science:
- Gastroenterology and Pharmacology
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) are globally prevalent analgesics.
- NSAID use significantly elevates gastrointestinal (GI) complication risks (2.5- to 5-fold).
Purpose of the Study:
- To outline risk factors and management strategies for NSAID-induced gastrointestinal adverse events.
- To provide guidance on balancing GI and cardiovascular risks with NSAID therapy.
Main Methods:
- Review of risk factors associated with NSAID-induced GI events.
- Analysis of gastroprotective co-therapy options for NSAID users.
- Evaluation of coxib and proton pump inhibitor (PPI) efficacy.
Main Results:
- High-risk factors include advanced age, prior ulcer history, high-dose NSAIDs, and concurrent anticoagulant/corticosteroid use.
- For high-risk patients, coxibs or NSAIDs with PPIs/misoprostol are recommended.
- Patients with ulcer bleeding require coxib plus PPI therapy, with H. pylori testing and treatment.
Conclusions:
- NSAID therapy necessitates careful risk assessment and minimization of dose and duration.
- Gastroprotective strategies are essential for patients with GI risk factors.
- Coxibs offer improved GI tolerance, and PPIs are effective for NSAID-induced dyspepsia.
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