セッション情報 The 4th International Forum

Short Oral Presentations(GI mucosal injury 2)

タイトル IF-SOP-5:

Low-dose aspirin-associated gastric and duodenal ulcers in Japanese patients with no previous history of peptic ulceration

演者 Tanabe Atsushi(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan)
共同演者 Ito Yoshitsugi(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Yamaguchi Sumiharu(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Okaniwa Noriko(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Noda Hisaya(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Yanamoto Kenichiro(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Tamura Yasuhiro(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Kondo Yoshihiro(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Masui Ryuta(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Izawa Shinya(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Hijikata Yasutaka(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Tokudome Kentaro(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Kawamura Naohiko(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Iida Akihito(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Ogasawara Naotaka(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Funaki Yasushi(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Sasaki Makoto(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan), Kasugai Kunio(Department of Gastroenterology, Aichi Medical University School of Medicine, Japan)
抄録 INTRODUCTION:Long-term administration of low-dose aspirin(LDA)is associated with a greater risk of adverse events, including gastroduodenal ulcers.
AIM:To assess the risk factors and the efficacy of medications for development of peptic ulcer disease in Japanese with no prior history of peptic ulceration.
METHODOLOGY:We conducted a matched background study using esophagogastroduodenoscopy(EGD)record collected from January 2010 through December 2010. Consecutive 219 outpatients receiving LDA(75 mg)who had not peptic ulcer history were matched to 1 control by age and sex who were not receiving LDA and had not peptic ulcer history. Clinical parameters, concomitant drugs, the reason for endoscopy, and endoscopic findings were analyzed.
RESULTS:Of 219 patients receiving LDA, 20(20%)was diagnosed endoscopically with peptic ulceration, which was significantly higher than 7(3.2%)of 219 patients not receiving LDA(OR, 3.0;95% CI, 1.26-7.35;P=0.016). In the patients receiving LDA, multiple logistic regression analysis revealed that male, diabetes mellitus(DM), or proton pump inhibitors(PPIs)were increased and decreased risk for peptic ulcer, respectively(OR, 5.2;95% CI, 1.12-24.51;P=0.035)(OR, 3.2;95% CI, 1.13-9.33;P=0.029)(OR, 0.22;95% CI, 0.06-0.80;P=0.022). Age, smoking habit, current alcohol consumption, H2-receptor antagonists, antiplatelet agents, and the reason for endoscopy were not significantly associated with the presence of peptic ulcers.
CONCLUSION:Long-term administration of LDA increase the risk of peptic ulcer even in the patients who had no peptic ulcer history, and PPIs reduces the risk of developing gastric or duodenal ulcers. However this risk is significantly increased in male and in DM patients. These results may help identify patients who require more intensive prophylaxis against aspirin-induced ulcerations.
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