Comparison of proton pump inhibitor and histamine-2 receptor antagonist in the prevention of recurrent peptic ulcers/erosions in long-term low-dose aspirin users: a retrospective cohort study.

Wen-Chi Chen,Hoi-Hung Chan,Yun-Da Li,Jin-Shiung Cheng,Feng-Woei Tsay,Po-Hung Chiang,Kwok-Hung Lai,Tzung-Jiun Tsai,E-Ming Wang,Wei-Lun Tsai

doi:10.1155/2014/693567

Abstract

Background. Proton pump inhibitor and histamine-2 receptor antagonist can prevent aspirin-related ulcers/erosions but few studies compare the efficacy of these two agents. Aims. We evaluated the efficacy of omeprazole and famotidine in preventing recurrent ulcers/erosions in low-dose aspirin users. Methods. The 24-week clinical outcomes of the patients using low-dose aspirin for cardiovascular protection with a history of ulcers/erosions and cotherapy of omeprazole or famotidine were retrospectively reviewed. The incidence of gastrointestinal symptoms, recurrent ulcers/erosions, erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was analyzed. Results. A total of 104 patients (famotidine group, 49 patients; omeprazole group, 55 patients) were evaluated. Famotidine group had more gastrointestinal symptoms episodes than omeprazole group (46.9% versus 23.6%, P = 0.01). Fifteen famotidine group patients and 5 omeprazole group patients had recurrent ulcers/erosions (30.6% versus 9.1%, P = 0.005). Lanza scale was significantly lower in omeprazole group than in famotidine group (1.2 ± 0.7 versus 1.7 ± 1.1, P = 0.008). Only 1 famotidine group patient had ulcer bleeding. The incidences of erosive esophagitis and thromboembolic events were comparable between both groups. Conclusions. Omeprazole was superior to famotidine with less gastrointestinal symptoms and recurrent ulcers/erosions in patients using 24-week low-dose aspirin. The risk of erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was similar between both groups.

Highlights

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with antiplatelet effect and has been widely used in primary or secondary prevention of cardiovascular and cerebrovascular events at a low dose of 75 to 325 mg daily [1,2,3]
We retrospectively reviewed the demographic data of the patients including age, gender, personal habits, concomitant diseases, indications of aspirin use, doses of aspirin, concomitant medications including steroids and short-term (
Of the 19 famotidine group patients with a history of H. pylori infection, H. pylori was successfully eradicated by using 7-day triple therapy (PPIs, amoxicillin, and clarithromycin for 7 days) (11 patients) and 14-day hybrid therapy (PPIs and amoxicillin for 14 days plus clarithromycin and metronidazole for 7 days) (8 patients)

Summary

Introduction

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with antiplatelet effect and has been widely used in primary or secondary prevention of cardiovascular and cerebrovascular events at a low dose of 75 to 325 mg daily [1,2,3]. We evaluated the efficacy of omeprazole and famotidine in preventing recurrent ulcers/erosions in low-dose aspirin users. The 24-week clinical outcomes of the patients using low-dose aspirin for cardiovascular protection with a history of ulcers/erosions and cotherapy of omeprazole or famotidine were retrospectively reviewed. The incidence of gastrointestinal symptoms, recurrent ulcers/erosions, erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was analyzed. Famotidine group had more gastrointestinal symptoms episodes than omeprazole group (46.9% versus 23.6%, P = 0.01). Fifteen famotidine group patients and 5 omeprazole group patients had recurrent ulcers/erosions (30.6% versus 9.1%, P = 0.005). Omeprazole was superior to famotidine with less gastrointestinal symptoms and recurrent ulcers/erosions in patients using 24-week low-dose aspirin. The risk of erosive esophagitis, gastrointestinal bleeding, and thromboembolic events was similar between both groups

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