Antiulcer Therapy in Nsaid Gastropathy: A Rheumatologist's Perspective

Abstract

Nonsteroidal anti-inflammatory drug (NSAID) gastropathy can now be recognized as an iatrogenic problem separate from classic acid peptic disease. Thus, the cost benefits of particular NSAID use is impacted by the hidden costs of common NSAID toxicity as well as gastroprotective measures necessary in those gastro-damaged by chronic NSAID use. Appropriate cytoprotective measures exist for serious gastropathy. A basis for selection of gastroprotective interventions also is available for that subset at greatest risk from continued, necessary NSAID therapy with associated potential putative consequences. Accepting this requires recognition that natural protective adaptation can fail in the face of such NSAID therapy and that the chronic gastric pathophysiology induced may be silent and ultimately catastrophic in outcome. Common symptomatic measures with H₂ blockade antacid agents are contrasted with cytoprotective potential of prostaglandin analogs and sucralfate as potentially more specific responses.

Keywords

Gastropathy Peptic ulcer Cytoprotection NSAID Arthritis therapy Ulcer therapy

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