Modern opportunities for treatment and prevention of NSAID-induced enteropathies

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are currently actively used in real clinical practice and everyday life with a wide range of pathological conditions and diseases, and are part of the medicinal arsenal of doctors of various specialties. Along with high pharmacotherapeutic efficacy according to the main indications, a whole range of various complications is associated with the use of NSAIDs. Of particular relevance is the negative specific effect of NSAIDs on the mucous membrane of the gastrointestinal tract. The problem of NSAID gastropathy is widely discussed in the literature, which is largely due to the possibilities of its prevention and treatment using proton pump inhibitors. For a long time, much less attention was paid to the issues of NSAID-dependent bowel damage, which may be associated with less instrumental diagnostic capabilities of these lesions and the lack of effective means for their prevention and treatment. The review presented addresses the pathogenesis, clinical features and diagnosis of NSAID enteropathy. Proton pump inhibitors effectively prevent the development of dyspepsia, erosion and ulcers, as well as gastrointestinal bleeding when taking NSAIDs at the level of the upper gastrointestinal tract, but they are ineffective in preventing and treating NSAID enteropathy. A new approach is the use of rebamipide, which has proven its clinical effectiveness in the prevention of NSAID-mediated Lesions in the upper and Lower gastrointestinal tract. Currently, rebamipid is included in the recommendations of the leading specialized communities in Russia and is recommended not only for the prevention and treatment of NSAIDs induced gastrointestinal lesions, but also as part of the complex therapy of peptic ulcer and anti-heLicobacter therapy. The review reviewed studies showing the efficacy and safety of rebamipide for the treatment and prevention of NSAID enteropathy.