Despite their first-line recommendation in OA, upper GI ulcer risk should be considered when using NSAIDsAssess your patient's risk
RESULTS FROM SEPARATE STUDIES SHOW THAT UPPER GI ULCERS:
ARE COMMONUp to1 in 4
chronic NSAID users may get an upper GI ulcer1
CAN BE ASYMPTOMATIC70%
of upper GI ulcers found in a small endoscopy study were asymptomatic
MAY OCCUR QUICKLY
Upper GI ulcers may form within6.5 days
of starting NSAID treatment3
*10 patients were found to have upper GI ulcers and only 3 patients had symptoms at the time of endoscopy.
Know your patients’ risk factors and take appropriate measures to reduce the risk of upper GI toxicity
High-dose NSAIDs alone put your patients at moderate risk for upper GI toxicity. The American College of Gastroenterology calculates upper GI risk by evaluating several common risk factors.1
See your patient’s risk by selecting the risk factors that apply to them.1†
0 risk factors
1-2 risk factors
>2 risk factors or history of a previously complicated ulcer, especially recent
Experts agree on the need for gastroprotection with NSAID use in patients at increased risk for NSAID GI toxicity1,4,5‡
†H. pylori is an independent and additive risk factor and needs to be addressed separately.
‡Serious GI events can occur at any time during NSAID use and without warning.6,7
GI=gastrointestinal; NSAID=nonsteroidal anti-inflammatory drug; OA=osteoarthritis; RA=rheumatoid arthritis.
- Lanza FL, Chan FK, Quigley EM, Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009;104(3):728-738.
- Larkai EN, Smith JL, Lidsky MD, Graham DY. Gastroduodenal mucosa and dyspeptic symptoms in arthritic patients during chronic nonsteroidal anti-inflammatory drug use. Am J Gastroenterol. 1987;82(11):1153-1158.
- Desai JC, Sanyal SM, Goo T, et al. Primary prevention of adverse gastroduodenal effects from short-term use of non-steroidal anti-inflammatory drugs by omeprazole 20 mg in healthy subjects: a randomized, double-blind, placebo-controlled study. Dig Dis Sci. 2008;53(8):2059-2065.
- Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474.
- Risser A, Donovan D, Heintzman J, Page T. NSAID prescribing precautions. Am Fam Physician. 2009;80(12):1371-1378.
- DUEXIS (ibuprofen and famotidine) [prescribing information] Horizon.
- VIMOVO (naproxen/esomeprazole magnesium) [prescribing information] Horizon.