Abstract:
BACKGROUND:Low-dose acetylsalicylic acid (ASA; aspirin; 75-325 mg/day) is effective for the prevention of cardiovascular events, and its use in this indication is rapidly increasing. However, the use of ASA and, indeed, other non-steroidal anti-inflammatory drugs (NSAIDs) is limited by the incidence of adverse gastroduodenal events. OBJECTIVES AND SCOPE: To review the clinical evidence for, and the pharmacodynamic basis of, ASA-induced gastroduodenal toxicity in comparison with NSAIDs, and address the question of whether low-dose ASA is 'safe' from a gastroduodenal perspective. This was a narrative, descriptive review, rather than a formal systematic review. FINDINGS:Adverse gastroduodenal effects, which are well known to occur with NSAIDs, are also prevalent in patients receiving low-dose ASA for cardiovascular protection even at doses as low as 75 mg/day. The risk of gastroduodenal toxicity is particularly high among 'at-risk' low-dose ASA patients (aged >70 years, previous ulcer or upper gastrointestinal bleeding and users of antiplatelets or NSAIDs). There are important differences in the mechanism of ASA-induced gastroduodenal toxicity, relative to NSAIDs. These differences include the effects on the cyclooxygenase (COX)-1 isoenzyme, local effects on the gastroduodenal mucosa specific to ASA and a reduction in platelet aggregation. CONCLUSION:Data suggest that ASA causes significant gastroduodenal damage even at the low doses used for cardiovascular protection. These effects (both systemic and possibly local) may be pharmacodynamically distinct from the gastroduodenal toxicity seen with NSAIDs. Studies are required to establish strategies for improving the tolerability of low-dose ASA, allowing patients to continue to benefit from the cardiovascular protection associated with such therapy.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Yeomans ND,Hawkey CJ,Brailsford W,Naesdal Jdoi
10.1185/03007990903212682subject
Has Abstractpub_date
2009-11-01 00:00:00pages
2785-93issue
11eissn
0300-7995issn
1473-4877journal_volume
25pub_type
杂志文章,评审abstract::In a general practice survey of the use of Temazepam 'Planpak' ('Planpak'), 31 participating doctors completed questionnaires on 250 patients. Of these, 228 patients had been taking a variety of 8 benzodiazepine hypnotics prior to 'Planpak' therapy while 22 (8.8%) patients received 'Planpak' as a short course, without...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007999109111510
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abstract::A multi-centre trial was carried out in 1629 patients with osteoarthrosis in 233 clinical centres to investigate the therapeutic efficacy and tolerability of indoprofen in this clinical condition. The results from assessments of both subjective and objective variables were comparable to those obtained in Phase 3 studi...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007997909109409
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abstract:OBJECTIVE:To demonstrate the equivalent efficacy of temazepam 7.5 mg and temazepam 15 mg for the treatment of transient insomnia. RESEARCH DESIGN AND METHODS:This was a double-blind, parallel group, multicenter study. Healthy male and female subjects with previous but not current complaints of transient insomnia were ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/030079904125003151
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abstract:OBJECTIVE:To estimate the costs and consequences of using pamidronate compared to zoledronic acid in the prophylactic management of skeletal morbidity among breast cancer patients in the UK. DESIGN AND SETTING:This was a modelling study performed from the perspective of the UK's National Health Service (NHS). METHODS...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079905X40472
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journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079906X167354
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journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2014.922944
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abstract:OBJECTIVES:The objective of this study was to analyze the characteristics and costs of exogenous endoscopy-related infections, pseudo-infections, and toxic reactions in the US. METHODS:A systematic review of the scientific literature published between 1966 and 2005 was conducted in Medline. Data collection was based o...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
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journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
doi:10.1185/03007995.2014.946127
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journal_title:Current medical research and opinion
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND:Omega-3 fatty acids from fish and fish oils can protect against coronary heart disease (CHD), which is still the most common cause of death in the Western economies. Evidence from epidemiological and case cohort studies indicate that consumpton of fatty fish and omega-3 fatty acids reduces the risk of cardio...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/030079904x17956
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abstract::A double-blind, randomized study was carried out in 43 women, who had undergone spontaneous menopause at least 6 months earlier, to compare the effectiveness and tolerance of veralipride with that of a conjugated oestrogens preparation in the control of hot flushes. Twenty-one women received 100 mg veralipride per day...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998409110119
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abstract::This double-blind, randomised, placebo-controlled study was carried out to assess the efficacy and safety of 0.025% and 0.05% azelastine eye drops twice daily administered for 14 days to patients with seasonal allergic conjunctivitis or rhinoconjunctivitis. A total of 278 patients were recruited and 226 patients were ...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007999709113339
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journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007995.2015.1018988
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journal_title:Current medical research and opinion
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doi:10.1185/03007995.2016.1140027
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journal_title:Current medical research and opinion
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/030079904125004187
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journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
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journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
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journal_title:Current medical research and opinion
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
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journal_title:Current medical research and opinion
pub_type: 杂志文章
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
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更新日期:1976-01-01 00:00:00