Summary
NSAID gastropathy is a serious, iatrogenic problem of common NSAID usage of major public health dimensions. Since ulcer bleeding and perforations can be disastrous, the issue clearly requires prevention.
Various gastroprotective therapies exist, but since symptoms do not predict the evolving pathophysiology in most cases, the problem continues to be underestimated in clinical care. Endoscopy is of definitive value, but not generally thought appropriate for screening purposes. Under these circumstances, not driven by putative symptomatology, a long term basis for compliance with gastroprotective therapies is potentially compromised and always expensive.
NSAID treatment strategy based on reducing putative gastrotoxicity is a primary goal. Present encouraging postmarketing surveillance experience, clinical research, and most recently, endoscopy evaluation suggest nabumetone as a potential prototype for a new generation of gastro-sparing NSAID therapies based on desirable pharmacological features.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Armstrong CP, Blower AL. Nonsteroidal anti-inflammatory drugs and life threatening complications of peptic ulceration. Gut 28: 527–532, 1987
Carson JL, Strom BL, Soper KA, West SL, Moree ML, et al. The association of nonsteroidal anti-inflammatory drugs with upper gastrointestinal tract bleeding. Archives of Internal Medicine 147: 85–88, 1987
Fries JF, Millwe AE, Spitz PQ, et al. Toward an epidemiology of gastropathy associated with nonsteroidal antiinflammatory drug use. Gastroenterology (Suppl. Part 2) 96: 647–655, 1988
Griffin MR, Ray WA, Schaffner W. Nonsteroidal anti-inflammatory drug use and death from peptic ulcer in elderly persons. Annals of Internal Medicine 109: 359–363, 1988
Mitchell DM, Spitz PW, Young DY, Bloch DA, McShane DJ, et al. Survival, prognosis, and causes of death in rheumatoid arthritis. Arthritis and Rheumatism 29: 706–714, 1986
Mowat AG. Nonsteroidal anti-inflammatory drug gastropathy in rheumatic conditions. Scandinavian Journal of Rheumatology (Suppl.) 78: 1–32, 1989
Roth SH. NSAID and gastropathy: a rheumatologist’s review. Journal of Rheumatology 15: 912–919, 1988a
Roth SH. Nonsteroidal anti-inflammatory drugs: gastropathy, deaths, and medical practice. Annals of Internal Medicine 109: 353–354, 1988b
Roth SH. Rethinking rheumatic disease therapy. Journal of Rheumatology 16: 1408–1409, 1989
Roth SH, Agrawal N, Mahowald M, Montoya H, Robbins D, et al. Misoprostol heals gastroduodenal injury in patients with rheumatoid arthritis receiving aspirin. Archives of Internal Medicine 149: 775–779, 1989
Roth SH, Bennett RE. Nonsteroidal anti-inflammatory drug gastropathy: recognition and response. Archives of Internal Medicine 147: 2093–2100, 1987
Roth SH, Bennett RE, Mitchell CS, Hartman RJ. Cimetidine therapy in nonsteroidal anti-inflammatory drug gastropathy: double-blind long-term evaluation. Archives of Internal Medicine 147: 1798–1801, 1987
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Roth, S.H. NSAID Gastropathy. Med Toxicol Adverse Drug Exp 40 (Suppl 5), 25–28 (1990). https://doi.org/10.2165/00003495-199000405-00006
Published:
Issue Date:
DOI: https://doi.org/10.2165/00003495-199000405-00006