New understanding about gastropathy associated with using of nonsteroidal anti-inflammatory drugs

Cover Page

Cite item

Full Text

Abstract

More than 30 million people take nonsteroidal anti-inflammatory drugs (NSAIDs). Regular use of NSAIDs is associated with a number of side effects and risks, the leader which are inflammatory, erosive and ulcerative changes of the mucous membrane of the gastrointestinal tract (GIT). NSAIDs can induce lesions of the GIT throughout its length from the esophagus to the rectum, but the lesion of the upper GIT develops in 6 times more often. NSAID gastropathy is a topical problem of modern clinical medicine, given the high prevalence and frequency of complications. Risk of NSAID-gastropathy is influenced by as factors as patient age, infection with Helicobacter pylori, the presence of complications of gastrointestinal diseases in the anamnesis, concomitant use of other drugs. Currently the most common of the strategies used for the prevention of NSAID-gastropathy is a combination therapy of NSAIDs with a proton pump inhibitor, and the use of selective cyclooxygenase-2 inhibitors. The introduction into clinical practice of new gastroprotective drug with proven effect - rebamipide - opens new prospects for the management of this difficult group of patients.

About the authors

I. V Maev

A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation

акад. РАН, д-р мед. наук, проф., зав. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И.Евдокимова», засл. врач РФ, засл. деятель науки РФ 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1

D. N Andreev

A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation

Email: dna-mit8@mail.ru
канд. мед. наук, ассистент каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И.Евдокимова» 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1

D. T Dicheva

A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation

канд. мед. наук, доц. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И.Евдокимова» 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1

E. V Zhilyaev

Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation; European Medical Center

д-р мед. наук, проф. каф. ревматологии ФГБОУ ДПО РМАНПО, глав. врач АО ЕМС, гл. внештатный специалист-ревматолог Департамента здравоохранения г. Москвы 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1; 123104, Russian Federation, Moscow, Spiridonevskii per., d. 5, str. 1

References

  1. Singh G. Gastrointestinal complications of prescription and over - the - counter nonsteroidal anti - inflammatory drugs: a view from the ARAMIS database. Arthritis, Rheumatism, and Aging Medical Information System. Am J Ther 2000; 7 (2): 115-21.
  2. Маев И.В., Самсонов А.А., Андреев Д.Н. Гастропатии, индуцированные нестероидными противовоспалительными средствами: патогенетически обоснованные подходы к профилактике и терапии. Фарматека. 2016; 2: 49-54.
  3. Tannenbaum H, Bombardier C, Davis P, Russel A.S. An Evidence - based approach to prescribing nonsteroidal anti - inflammatory drugs. Third Canadian Consensus Conference. J Rheumatol 2006; 33: 140-57.
  4. Lanas A, Chan F.K. Peptic ulcer disease. Lancet 2017 Feb 23. pii: S0140-6736(16)32404-7.
  5. Lanas A, Perez-Aisa M.A, Feu F et al. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal antiinflammatory drug use. Am J Gastroenterol 2005; 100 (8): 1685-93.
  6. Roth S.H. Nonsteroidal anti - inflammatory drug gastropathy. We started it - can we stop it? Arch Intern Med 1986; 146 (6): 1075-6.
  7. Sostres C, Gargallo C.J, Lanas A. Nonsteroidal anti - inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis Res Ther 2013; 15 (Suppl. 3): S3.
  8. Melcarne L, García-Iglesias P, Calvet X. Management of NSAID-associated peptic ulcer disease. Expert Rev Gastroenterol Hepatol 2016; 10 (6): 723-33.
  9. Larkai E.N, Smith J.L, Lidsky M.D, Graham D.Y. Gastroduodenal mucosa and dyspeptic symptoms in arthritic patients during chronic nonsteroidal anti - inflammatory drug use. Am J Gastroenterol 1987; 82 (11): 1153-8.
  10. Lanas Á, Carrera-Lasfuentes P, Arguedas Y et al. Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal anti - inflammatory drugs, antiplatelet agents, or anticoagulants. Clin Gastroenterol Hepatol 2015; 13 (5): 906-12.e2.
  11. Lewis S.C, Langman M.J, Laporte J.R et al. Dose - response relationships between individual nonaspirin nonsteroidal anti - inflammatory drugs (NANSAIDs) and serious upper gastrointestinal bleeding: a meta - analysis based on individual patient data. Br J Clin Pharmacol 2002; 54 (3): 320-6.
  12. Castellsague J, Riera-Guardia N, Calingaert B et al. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta - analysis of observational studies (the SOS project). Drug Saf 2012; 35 (12): 1127-46.
  13. Bhala N, Emberson J, Merhi A et al. Vascular and upper gastrointestinal effects of non - steroidal anti - inflammatory drugs: meta - analyses of individual participant data from randomised trials. Lancet 2013; 382 (9894): 769-79.
  14. Gargallo C.J, Sostres C, Lanas A. Prevention and Treatment of NSAID Gastropathy. Curr Treat Options Gastroenterol 2014; 12 (4): 398-413.
  15. Маев И.В., Самсонов А.А., Андреев Д.Н. Болезни желудка. М.: ГЭОТАР-Медиа, 2015.
  16. De Ruiter J. Non - steroidal antiinflammatory drugs (NSAIDS). Principles of Drug Action 2002; 2: 1-25.
  17. Sostres C, Gargallo C.J, Arroyo M.T, Lanas A. Adverse effects of non - steroidal anti - nflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol 2010; 24: 121-32.
  18. Zidar N, Odar K, Glavac D et al. Cyclooxygenase in normal human tissues - is COX-1 really a constitutive isoform, and COX-2 an inducible isoform? Cell Mol Med B 2009; 13 (9): 3753-63.
  19. Laine L. Nonsteroidal anti - inflammatory drug gastropathy. Gastrointest Endosc Clin N Am 1996; 6 (3): 489-504.
  20. Mitchell J.A, Akarasereenont P, Thiemermann C et al. Selectivity of nonsteroidal antiinflammatory drugs as inhibitors of constitutive and inducible cyclooxygenase. Proceedings of the National Academy of Sciences of the United States of America. 1993; 90 (24): 11693-7.
  21. Gudis K, Sakamoto C. The role of cyclooxygenase in gastric mucosal protection. Dig Dis Sci 2005; 50 (1): S16-S23.
  22. Konturek S.J, Konturek P.C, Pawlik T et al. Duodenal mucosal protection by bicarbonate secretion and its mechanisms. J Physiol Pharmacol 2004; 55: 5-17.
  23. Свинцицкий А.С. НПВП гастродуоденопатии у больных остеоартрозом: особенности диагностики, профилактики и лечения. Научно - практическая ревматология. 2002; 3: 26-31.
  24. Hudson N, Balsitis M, Everitt S, Hawkey C.J. Enhanced gastric mucosal leukotriene B4 synthesis in patients taking non - steroidal anti - inflammatory drugs. Gut 1993; 34 (6): 742-7.
  25. Vaananen P.M, Keenan C.M, Grisham M.B, Wallace J.L. Pharmacological investigation of the role of leukotrienes in the pathogenesis of experimental NSAID gastropathy. Inflammation 1992; 16 (3): 227-40.
  26. Andrews F.J, Malcontenti-Wilson C, O’Brien P.E. Effect of nonsteroidal anti - inflammatory drugs on LFA-1 and ICAM-1 expression in gastric mucosa. Am J Physiol 1994; 266 (4, part 1): G657-G664.
  27. Mc Cafferty D.M, Granger D.N, Wallace J.L. Indomethacin - induced gastric injury and leukocyte adherence in arthritic versus healthy rats. Gastroenterology 1995; 109 (4): 1173-80.
  28. Насонов Е.Л., Каратеев А.Е. Поражения желудка, связанные с приемом нестероидных противовоспалительных препаратов (часть I). Клин. мед. 2000; 3: 4-9.
  29. Fiorucci S, Antonelli E, Morelli A. Mechanism of non - steroidal anti - inflammatory drug - gastropathy. Digest Liver Dis 2001; 33 (Suppl. 2): S35.
  30. Маев И.В., Самсонов А.А., Андреев Д.Н. Инфекция Helicobacter pylori. М.: ГЭОТАР-Медиа, 2016.
  31. Huang J.Q, Sridhar S, Hunt R.H. Role of Helicobacter pylori infection and non - steroidal anti - inflammatory drugs in peptic - ulcer disease: a meta - analysis. Lancet 2002; 359 (9300): 14-22.
  32. Lim Y.J, Hong S.J. Helicobacter pylori infection in nonsteroidal anti - infl ammatory drug users. Korean J Gastroenterol 2014; 64 (2): 70-5.
  33. Malfertheiner P, Megraud F, O'Morain C.A et al. Management of Helicobacter pylori infection - the Maastricht V/Florence Consensus Report. Gut 2017; 66 (1): 6-30.
  34. Lanza F.L, Chan F.K, Quigley E.M. Practice Parameters Committee of the American College of Gastroenterology, Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009; 104 (3): 728-38.
  35. Laine L. The role of proton pump inhibitors in NSAID - associated gastropathy and upper gastrointestinal symptoms. Rev Gastroenterol Dis 2003; 3 (4): S30-S39.
  36. Micklewright R, Lane S, Linley W et al. Review article: NSAIDs, gastroprotection and cyclo - oxygenase - II - selective inhibitors. Aliment Pharmacol Ther 2003; 17 (3): 321-32.
  37. Patrignani P, Tacconelli S, Capone M.L. Risk management profile of etoricoxib: an example of personalized medicine. Ther Clin Risk Management 2008; 4 (5): 983-97.
  38. Trelle S, Reichenbach S, Wandel S et al. Cardiovascular safety of non - steroidal antiinflammatory drugs: network meta - analysis. BMJ 2011; 342: 7086.
  39. Bombardier C, Laine L, Reicin A et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. N Engl J Med 2000; 343 (21): 1520-8.
  40. Schwartz J, Dallob A, Larson P et al. Comparative inhibitory activity of etoricoxib, celecoxib, and diclofenac on COX-2 versus COX-1 in healthy subjects. J Clin Pharmacol 2008; 48 (6): 745-54.
  41. Chan F, Lanas A, Scheiman J et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet 2010; 376: 173-9.
  42. Goldstein J, Eisen G, Lewis B et al. Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol 2005; 3: 3-13.
  43. Mattia C, Coluzzi F. COX-2 inhibitors: pharmacological data and adverse effects. Minerva Anesthesiology 2005; 71 (7-8): 461-70.
  44. Nguyen A, Chaiton A. Cyclooxygenase (COX-2) selective inhibitors: any better than NSAIDs? Can Fam Physician 2001; 47: 1398-400.
  45. Laine L. Proton pump inhibitor co - therapy with nonsteroidal anti - inflammatory drugs - nice or necessary? Rev Gastroenterol Dis 2004; 4 (Suppl. 4): S33-S41.
  46. Vergara M, Catalan M, Gisbert J.P et al. Meta - analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users. Aliment Pharmacol Ther 2005; 21: 1411e18.
  47. Koch M. Non - steroidal anti - inflammatory drug gastropathy: clinical results with misoprostol. Ital J Gastroenterol Hepatol 1999; 31 (1): S54-S62.
  48. Silverstein F.E, Graham D.Y, Senior J.R et al. Misoprostol reduces serious gastrointestinal complications in patients with rheumatoid arthritis receiving nonsteroidal anti - inflammatory drugs. A randomized, double - blind, placebo - controlled trial. Ann Intern Med 1995; 123 (4): 241-9.
  49. Graham Y, White R.H, Moreland L.W et al. Duodenal and gastric ulcer prevention with misoprostol in arthritis patients taking NSAIDs. Misoprostol Study Group. Ann Intern Med 1993; 119 (4): 257-62.
  50. Iinuma S, Naito Y, Yoshikawa T et al. In vitro studies indicating antioxidative properties of rebamipide. Dig Dis Sci 1998; 43 (Suppl. 9): 35S-39S.
  51. Yoshida N, Yoshikawa T, Iinuma S et al. Rebamipide protects against activation of neutrophils by Helicobacter pylori. Dig Dis Sci 1996; 41 (6): 1139-44.
  52. Naito Y, Yoshikawa T. Rebamipide: a gastrointestinal protective drug with pleiotropic activities. Exp Rev Gastroenterol Hepatol 2010; 4 (3): 261-70.
  53. Zhang S, Qing Q, Bai Y et al. Rebamipide helps defend against nonsteroidal anti - inflammatory drugs induced gastroenteropathy: a systematic review and meta - analysis. Dig Dis Sci 2013; 58 (7): 1991-2000.
  54. Kim J.H, Park S.H, Cho C.S et al. Preventive efficacy and safety of rebamipid in NSAD-indused toxicity. Gut Liver 2014; 8 (4): 371-79.
  55. Park S.H, Cho C.S, Lee O.Y et al. Comparison of Prevention of NSAID-Induced Gastrointestinal Complications by Rebamipide and Misoprostol: A Randomized, Multicenter, Controlled Trial-STORM STUDY. J Clin Biochem Nutr 2007; 40 (2): 148-55.
  56. Tozawa K, Oshima T, Okugawa T et al. A Randomized, Double - Blind, Placebo - Controlled Study of Rebamipide for Gastric Mucosal Injury Taking Aspirin With or Without Clopidogrel. Dig Dis Sci 2014; 59 (8): 1885-90.
  57. Suzuki T, Yoshida N, Nakabe N et al. Prophylactic effect of rebamipide on aspirin - induced gastric lesions and disruption of tight junctional protein zonula occludens-1 distribution.J Pharmacol Sci 2008; 106 (3): 469-77.

Copyright (c) 2017 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies