EFFECT OF CONCURRENT RABEPRAZOLE ON THE INCIDENCE OF PEPTIC ULCER DISEASE IN PATIENTS TAKING CHRONIC NON-STEROIDAL ANTI-INFLAMMATORY DRUGS

Abstract

Purpose: To demonstrate whether the proton pump inhibitor rabeprazole can reduce the incidence of peptic ulcer disease in patients taking chronic Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Methods: The study was conducted by reviewing electronic pharmacy and medical records at the Veteran's Administration Medical Center, Salem VA for the period from 01 October 1999 through 30 September 2002 (36 months). A total of 2849 patients taking chronic NSAIDs and rabeprazole were identified and all peptic ulcers accounted for in the study were documented either by esophagogastroduodenoscopy (EGD) or by upper gastrointestinal contrast roentgenography (UGI). Chronic NSAID use was defined as a minimum twice a day use for a period of at least two weeks. Patients using selective COX-2 inhibitors, systemic steroids orbisphosphonates were excluded from the study. All patients in the studied group were prescribed rabeprazole prior to NSAIDs. Results: Among the reviewed patients, 18 had documented peptic ulcers (incidence rate of 0.63%). This rate is significantly lowerthan what has been reported in the literature for the rate of peptic ulcer disease in patients using chronic NSAIDs alone. According to the data from reviewed publications rate of peptic ulcers in patients using non-steroidal anti-inflammatory drugs was anywhere from 10% to 25%. Conclusions: This data may suggest that use of rabeprazole in patients taking NSAIDs on a chronic basis may reduce the rate of peptic ulcer disease.