Nonsteroidal Anti-Inflammatory Drugs Induce Asymptomatic Gastroduodenal Ulcers in the Japanese Population: A Case-Control Study on Its Prevalence and the Protective Effect of Anti-Ulcer Agents

DOI Web Site 被引用文献3件 参考文献32件 オープンアクセス
  • Kawabe Masato
    Department of Gastroenterology, Juntendo University School of Medicine
  • Miwa Hiroto
    Division of Upper Gastroenterology, Department of Gastroenterology, Hyogo College of Medicine
  • Ohkusa Toshifumi
    Department of Gastroenterology, Juntendo University School of Medicine
  • Yokoyama Tetsuji
    Department of Technology Assessment and Biostatistics, National Institute of Public Health
  • Kurosawa Akihiko
    Department of Gastroenterology, Juntendo University School of Medicine
  • Asaoka Daisuke
    Department of Gastroenterology, Juntendo University School of Medicine
  • Hojo Mariko
    Department of Gastroenterology, Juntendo University School of Medicine
  • Nagahara Akihito
    Department of Gastroenterology, Juntendo University School of Medicine
  • Tsuda Hiroshi
    Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine
  • Sato Nobuhiro
    Department of Gastroenterology, Juntendo University School of Medicine

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We report the first case-control study in Japan on the prevalence of non-steroidal anti-inflammatory drug (NSAID)-induced gastroduodenal ulcer and the prophylactic effect of co-administered anti-ulcer drugs in regular NSAID users. The NSAID users were 125 patients with rheumatoid arthritis (RA) and without gastrointestinal symptoms while regularly taking NSAIDs (>1 month). The NSAID non-users were125 age- and sex-matched healthy individuals seen between April 2001 and September 2003. Gastric ulcer prevalence was significantly higher among NSAID users than non-users and the odds ratio was 9.50 (95% CI: 2.21-40.8), while that of duodenal ulcers and reflux esophagitis was similar between users and non-users and the odds ratios were 1.11 (0.45-2.73) and 2.00 (0.68-5.85), respectively. The odds ratios for ulcers with concomitant treatment with a proton pump inhibitor or prostaglandin E1 analogue were 0.12 and 0.72 respectively, and were even lower than H2 receptor antagonist and mucosal-protective drug. In conclusion, gastric ulcer prevalence was significantly higher in Japanese RA patients using NSAIDs than in healthy non-users. Concomitant proton pump inhibitor or prostaglandin therapy was effective in preventing NSAID-induced ulcers.

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