Effect of Antiulcer Drugs for Treatment of Nonsteroidal Antiinflammatory Drug-Induced Ulcers

It is difficult to heal ulcers during continuous administration of nonsteroidal autiinflammatory drugs (NSAIDs). We retrospectively studied 136 rheumatoid arthritis patients who were taking NSAIDs at least 3 months, and who could be followed within 12 weeks of being diagnosed with an ulcer using endoscopy. Among patients who had ulcers in the antrum (A region), healing rates were 46.7% (21/45), 46.7% (21/45), and 73.3% (11/15) in the famotidine (F) group, lansoprazole (L) group, and misoprostol (MP) group, respectively; the rate was higher in the MP group than in the F and L groups. On the other hand, for ulcers in the body (M region) there were no differences among the groups; healing rates were 94.1% (16/17), 86.7% (13/15), and 100% (1/1), respectively. To study the background regarding A region ulcers and cardia/body (C/M) region ulcers, we studied acid output and Helicobacterpylori (HP)-positive rates. There were no differences in acid output between the two groups. In the NSAID group, the HP-positive rate was significantly lower among A region ulcers (48.3%) than in C/M region ulcers (100%). A large-scale, multicenter study that also considers the role of HP is needed to establish the best treatment of NSAIDS-induced ulcers.