Prevention of non-steroidal anti-inflammatory drug-induced gastrointestinal mucosal injury: risk factors for serious complications.

摘要: Abstract Background . 1–2% of all patients under non-steroidal anti-inflammatory drug therapy are exposed to serious upper gastrointestinal complications. The policy prevention drug-induced mucosal injury by using misoprostol or suppressing acid secretion is still a matter debate. Aims To discuss the effectiveness prophylaxis complication during treatment, according number and relevance risk factors. Patients A total 8.843 with rheumatoid arthritis, admitted widest prospective multi-centre mega-trial, on 6-month induced ulcers. Methods results presented in terms be treated (number needed treat) order prevent one complication, corrected for patients, that receiving therapy, would lead additional withdrawal harm). Results base-line strongly depended factors: history peptic ulcer disease, bleeding, cardiovascular age. In general study population, relative reduction complications was 40%: thus treat 1 event 250 experimental period (6 months) 125 when normalized at year treatment (1 treat). When considering gain intermediate (risk 1–2%) high subjects (patients probability an over 2%, presence important factor multiple factors), 1-year rapidly drops from about 100 17. harm 18. withdrawals avoid major rises 132 population users; 102 105 risk, such as disease; groups 26 27 disease), 16 17 disease aged 65 years). Conclusions ulcers should considered prophylaxis. this group severe effective, its clinical similar other preventive measures medical practice.