PMID- 11742186
OWN - NLM
STAT- MEDLINE
DCOM- 20020313
LR  - 20190906
IS  - 0954-691X (Print)
IS  - 0954-691X (Linking)
VI  - 13
IP  - 12
DP  - 2001 Dec
TI  - Gastro-duodenal protection in an era of cyclo-oxygenase-2-selective nonsteroidal 
      anti-inflammatory drugs.
PG  - 1401-6
AB  - Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective and necessary for the 
      relief of pain and inflammation in patients with arthritis. NSAIDs are however 
      also associated with an increased risk for ulceration in the stomach and in the 
      duodenum, and many NSAID users experience bothersome dyspeptic symptoms during 
      continued NSAID therapy. PPIs like omeprazole, have been shown to heal and to 
      prevent ulcers and dyspeptic symptoms during continued NSAID therapy, and during 
      continued NSAID therapy the prostaglandin analogue, misoprostol, has been shown 
      to reduce the risk for ulcer complications. The COX-2 selective NSAID, rofecoxib, 
      is in comparison with naproxen, a non-selective NSAID, associated with fewer 
      clinically important upper gastrointestinal events. The incidence of myocardial 
      infarctions seems, however, to be lower with naproxen than with rofecoxib, and 
      this is expected to lead to low-dose aspirin use in rofecoxib users at risk for 
      cardiovascular events. Co-administration of the COX-2 selective NSAID, celecoxib, 
      and low-dose aspirin, is associated with the same risk for upper gastrointestinal 
      ulcer complications alone and combined with symptomatic ulcers, as the 
      non-selective NSAIDs, ibuprofen and diclofenac. A proton pump inhibitor (PPI) 
      should be used for healing of NSAID-associated ulcers, and a PPI or misoprostol 
      should be considered for prevention of ulceration in non-selective NSAID users at 
      risk for ulceration. The experience with COX-2 selective NSAIDs is still limited, 
      and it remains to be studied whether subpopulations of COX-2 selective NSAID 
      users will benefit from gastro-duodenal protection.
FAU - Naesdal, J
AU  - Naesdal J
AD  - Clinical Science, AstraZeneca R&D Molndal, Sweden. jorgen.naesdal@astrazeneca.com
FAU - Wilson, I
AU  - Wilson I
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Cyclooxygenase 2 Inhibitors)
RN  - 0 (Cyclooxygenase Inhibitors)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Isoenzymes)
RN  - 0 (Membrane Proteins)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0E43V0BB57 (Misoprostol)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - EC 1.14.99.1 (Cyclooxygenase 2)
RN  - EC 1.14.99.1 (PTGS2 protein, human)
RN  - EC 1.14.99.1 (Prostaglandin-Endoperoxide Synthases)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Cyclooxygenase 2
MH  - Cyclooxygenase 2 Inhibitors
MH  - Cyclooxygenase Inhibitors/*adverse effects
MH  - Histamine H2 Antagonists/*therapeutic use
MH  - Humans
MH  - Isoenzymes/*antagonists & inhibitors
MH  - Lansoprazole
MH  - Membrane Proteins
MH  - Misoprostol/therapeutic use
MH  - Omeprazole/*analogs & derivatives/therapeutic use
MH  - Peptic Ulcer/chemically induced/*prevention & control
MH  - Prostaglandin-Endoperoxide Synthases
MH  - *Proton Pump Inhibitors
RF  - 42
EDAT- 2001/12/14 10:00
MHDA- 2002/03/14 10:01
CRDT- 2001/12/14 10:00
PHST- 2001/12/14 10:00 [pubmed]
PHST- 2002/03/14 10:01 [medline]
PHST- 2001/12/14 10:00 [entrez]
AID - 10.1097/00042737-200112000-00001 [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2001 Dec;13(12):1401-6. doi: 
      10.1097/00042737-200112000-00001.