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AB0987 Recurrence of Nsaid - Induced Ulcers: Has The Situation Changed in Recent Years?
  1. A. Karateev,
  2. A. Tsurgan,
  3. N. Gontarenko
  1. V. A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation


Background Gastric or duodenal ulcers are one of the most common side effects of NSAIDs. These lesions are important as a cause of of life-threatening complications, such as GI-bleeding. Therefore, patients who had NSAIDs-induced ulcers in history require special control for the prophylaxis of GI-complications if they need to continue to use NSAIDs.

Objectives To compare the frequency of relapses of NSAIDs-induced ulcers in patients with rheumatic diseases who had long-term use of NSAIDs during the periods of 1996–2006 and 2011–2013.

Methods Group 1 (1996–2006): 407 pts (85.3% females, 52.1±13.6 y.o.), with gastric or duodenal ulcers, which developed during NSAIDs treatment; and 1640 pts (83.1% females, aged 50.1±14.6 y.o.), who didn't develop ulcer during NSAIDs intake. Group 2 (2011–2013): 82 pts (80.6% females, 58.3±12.7) with NSAIDs-induced gastric or duodenal ulcers, and 206 pts (85.1% females, 51.7±15.2 y.o.), without GI lesions during NSAIDs therapy. Patients from Group 1 used selective COX-2 inhibitors (coxibs) less in comparison to pts from Group – 4.9% vs 15.7%, as well as proton pump inhibitors (PPIs) – 14.6% vs 47.6% (p=0.000). All pts continued to use NSAIDs at least for one year after the first upper gastrointestinal endoscopy (UGE). All patients underwent repeated UGE after 12 months.

Results Relapse of NSAID-induced ulcers were documented in 40.7% pts from Group 1, and in 28.0% pts from Group 2. Another situation was observed in patients of group 1 and 2 who did not have NSAID-induced GI lesions according data of first UGE. All of them continued to use NSAIDs ≥12 month and only 6.5% and 2.4% had developed ulcers according data of second UGE, respectively. PPI use significantly reduced the risk of relapsing NSAIDs-induced ulcers in Group 1 and 2: odds ratio (OR) 0.51 (95% CI 0.28–0.67) and OR 0.47 (95% CI 0.11–0.74).

Conclusions Relapses of NSAID-induced ulcers still remain a serious problem. Pts with NSAID-induced ulcers in history should be protected with PPIs if they require continuation of using NSAIDs. Patients, who have not observed the development of NSAID-gastropathy with short-term NSAID therapy, have a lower risk of developing these lesions by continuing to use them for a long time.

Disclosure of Interest None declared

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