Endoscopic Evaluation of Non-steroidal Anti-inflammatory Drug (NSAID)-induced Gastric and Duodenal Ulcers during Prophylaxis with Lansoprazole

Nobuhiro Sakaki, Kiyoshi Ashida, Yuji Mizokami, Masahiro Asaka, Shigeyuki Matsui, Tatsuya Kanto, Hideyuki Hiraishi, Naoki Hiramatsu, Kentaro Sugano


AIM: There are very few detailed reports on the features of gastric and/or duodenal ulcers associated with non-steroidal antiinflammatory drugs (NSAIDs) during ulcer prophylaxis. In this study, lansoprazole (LPZ) and gefarnate (GFN) were compared for efficacy in the prophylaxis of gastric and duodenal ulcers in high-risk patients receiving NSAID therapy. MTTHODS: All ulcers that had developed during prophylaxis with LPZ (15 mg once daily) and GFN (50 mg twice daily) in a prospective, randomized, double-blind trial were compared for their endoscopic features by a panel of expert endoscopists based on their endoscopic images, in accordance with a predetermined set of criteria. RESULTS: A total of 15 and 46 patients had developed gastric or duodenal ulcers during prophylaxis with LPZ and GFN, respectively, during the double-blind trial. Of the 14 gastric ulcers that had developed in those given LPZ, 13 (93%) were “small” and “shallow”,while, in contrast, 31% of 35 gastric ulcers were “medium” or “large” and 29% were deep” in those given GFN. On the other hand, 8 out of 11 patients had “deep” duodenal ulcers in the GFN group while 1 patient a “medium” and “shallow” duodenal ulcer in the LPZ group. CONCLUSIONS: The study results demonstrated that ulcers developing during secondary prophylaxis with LPZ and GFN differ in their size and depth. These findings may be useful when devising a strategy for the prevention of gastric and duodenal ulcers in highrisk patients receiving NSAID therapy in a routine clinical setting.

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