Current States of Prevention of Drug-induced Gastroduodenal Ulcer in Real Clinical Practice: a Cross-sectional Study

Overview

Journal J Clin Biochem Nutr

Specialty Biochemistry

Date 2020 Apr 2

PMID 32231413

Citations 1

Authors

Junichi Iwamoto

Masashi Murakami

Tadakuni Monma

Hajime Ueda

Makoto Tamamushi

Naoki Konishi

Sho-Ichiro Yara

Takeshi Hirayama

Tadashi Ikegami

Akira Honda

Yuji Mizokami

Affiliations

Soon will be listed here.

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin (LDA) are the most common causes of drug-induced gastroduodenal ulcer and We investigated preventive treatment with use of concomitant anti-ulcer drugs and the clinical features of gastroduodenal ulcer in cases treated with these drugs. Patients with gastroduodenal ulcer and patients with bleeding were classified into 3 groups: LDA, non-aspirin NSAIDs, and those taking neither aspirin nor NSAIDs. Chronological changes over the past 16 years (1st-5th period) were investigated. The status of prevention of ulcer and clinical features were examined. From January 2002 to December 2018, the ratio of all patients taking NSAIDs and LDA increased significantly until 3rd period (<0.05), but then started to decrease in 4th period; and the percentage of all patients taking NSAIDs and LDA decreased significantly (<0.05) until 5th period. Among the 292 patients with gastroduodenal ulcer and the 121 patients with a bleeding ulcer taking NSAIDs and LDA, 16 (5.5%) and 9 (7.4%), respectively, were receiving preventive treatment with concomitant anti-ulcer drugs. The percentages of patients taking LDA and other antiplatelet drugs in patients with bleeding gastroduodenal ulcer were significantly higher than those in patients with non-bleeding. In conclusion, although the percentages of patients with gastroduodenal ulcer taking NSAIDs or LDA have not recently increased in real-world practice, preventive treatment in these patients is still low. This low rate of prevention suggests the need to enlighten physicians about preventive treatment because drug withdrawal of LDA has a high risk of cardiovasculr and cerebrovascular events.

Citing Articles

Decline incidence in upper gastrointestinal bleeding in several recent years: data of the Japan claims database of 13 million accumulated patients.

Fujimoto S, Tsuruoka N, Esaki M, Takamori A, Sakata Y, Shimoda R J Clin Biochem Nutr. 2021; 68(1):95-100.

PMID: 33536718 PMC: 7844659. DOI: 10.3164/jcbn.20-153.

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