Prevention of adverse gastrointestinal events of nonsteroidal anti-inflammatory drugs with proton pump inhibitors. Results of the epidemiologic study GREAT

Czech version

Authors: Š. Forejtová; K. Pavelka; Z. Mareš
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 19, 2011, No. 3, p. 104-110.
Category: Original Papers

Overview

The aim of our study
was to survey the forms of gastroprotective therapy used in the Czech Republic during the treatment with nonsteroidal anti-rheumatic drugs (NSAIDs) in patients with chronic rheumatic diseases with different risk factors for NSAID-induced gastropathy.

Methods:
We conducted a multicentric study with data collected directly by rheumatologists. Administration of NSAIDs for at least 4 days a week in the last 3 months was considered as chronic use. The study had two parts: the first part was a cross-sectional study with a one-time record of use of gastroprotective therapy at the time of questionnaire completion; the second part was a retrospective observation of adverse effects in the last 3 months.

Results:
90 rheumatologists participated in our survey. Records were collected for a total of 869 patients: 275 men (31.65%) and 594 women (68.35%). A total of 789 patients (90.79%) were at risk of NSAID-induced gastropathy; with 397 (45.68%) at high-risk and 392 patients (45.10%) at low risk. At least one gastroprotective drug was used in 648 (74.57%) individuals (coxibs, H2-blockers or proton pump inhibitors), with omeprazole being the most commonly used gastroprotective agent (94.41%). The relationship between risk of NSAID-induced gastropathy and gastroprotective agent used reached statistical significance (p<0.01, r = 0.349); ie gastroprotective drugs were used in 83.88% patients at high risk of gastropathy, in 73.72% patients with low risk, and in 32.50% patients with no risk. No gastroprotective drugs were used in 16.18% high-risk patients and in 26.27% patients with low risk of gastropathy. 672 (77.33%) out of all monitored individuals experienced no difficulties during the NSAIDs treatment, whereas 197 (22.66%) individuals had some ailments under the treatment with NSAIDs.

Conclusion:
We have found a significant correlation between the GI risk and use of gastroprotective drug. The most commonly used agent was omeprazole (94.41%). However 19.22% of all monitored individuals with at least one risk factor for NSAID-induced gastropathy were not treated with any gastroprotective drug.

Key words:
NSAID-induced gastropathy, gastroprotective therapy, proton pump inhibitors, omeprazole

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Article was published in

Czech Rheumatology

2011 Issue 3