Nonsteroid anti-inflammatory drug-induced gastroduodenal injury

被引：18

作者：

Lai, Larry H. ^{[1
]}

Chan, Francis K. L. ^{[1
]}

机构：

[1] Chinese Univ Hong Kong, Inst Digest Dis, Hong Kong, Hong Kong, Peoples R China

来源：

CURRENT OPINION IN GASTROENTEROLOGY | 2009年 / 25卷 / 06期

关键词：

aspirin; clopidogrel; cyclooxygenase-2; gastrointestinal bleeding; nonsteroid anti-inflammatory drug; peptic ulcer; proton pump inhibitor; PROTON-PUMP INHIBITORS; GASTROINTESTINAL ULCER COMPLICATIONS; LOW-DOSE ASPIRIN; NSAID USE; ANTIPLATELET AGENTS; CARDIOVASCULAR RISK; COST-EFFECTIVENESS; CONCOMITANT USE; CLINICAL-TRIAL; CLOPIDOGREL;

D O I：

10.1097/MOG.0b013e328331549f

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Purpose of review This article reviews selected publications related to nonsteroid anti-inflammatory drug (NSAID)-induced gastroduodenal toxicity in recent years. Recent findings This article provides a comprehensive review of the latest evidence on the epidemiology of NSAID-induced gastroduodenal injury, recommendations on optimal gastroprotective regimens among patients in need of NSAID, risk stratification approach by considering gastrointestinal and cardiovascular risks, and negative interaction between proton pump inhibitors (PPIs) and clopidogrel. Summary Current evidence indicates that a PPI and a cyclooxygenase (COX)-2-selective NSAID provides the best gastric protection. In light of potential cardiovascular hazard of NSAIDs, physicians should select an NSAID according to individual patients' cardiovascular risk (i.e., naproxen vs. a nonnaproxen NSAID). The choice of gastroprotective therapy depends on the number and nature of gastrointestinal risk factors. PPI co-therapy is recommended in patients with high gastrointestinal risk on aspirin. Whether there is any clinically important interaction between PPIs and clopidogrel remains uncertain.

引用

页码：544 / 548

页数：5

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