Non-steroidal anti-inflammatory drug (NSAID) therapy in patients with hypertension, cardiovascular, renal or gastrointestinal comorbidities: joint APAGE/APLAR/APSDE/APSH/APSN/PoA recommendations.

Abstract:

BACKGROUND:Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medications, but they are associated with a number of serious adverse effects, including hypertension, cardiovascular disease, kidney injury and GI complications. OBJECTIVE:To develop a set of multidisciplinary recommendations for the safe prescription of NSAIDs. METHODS:Randomised control trials and observational studies published before January 2018 were reviewed, with 329 papers included for the synthesis of evidence-based recommendations. RESULTS:Whenever possible, a NSAID should be avoided in patients with treatment-resistant hypertension, high risk of cardiovascular disease and severe chronic kidney disease (CKD). Before treatment with a NSAID is started, blood pressure should be measured, unrecognised CKD should be screened in high risk cases, and unexplained iron-deficiency anaemia should be investigated. For patients with high cardiovascular risk, and if NSAID treatment cannot be avoided, naproxen or celecoxib are preferred. For patients with a moderate risk of peptic ulcer disease, monotherapy with a non-selective NSAID plus a proton pump inhibitor (PPI), or a selective cyclo-oxygenase-2 (COX-2) inhibitor should be used; for those with a high risk of peptic ulcer disease, a selective COX-2 inhibitor plus PPI are needed. For patients with pre-existing hypertension receiving renin-angiotensin system blockers, empirical addition (or increase in the dose) of an antihypertensive agent of a different class should be considered. Blood pressure and renal function should be monitored in most cases. CONCLUSION:NSAIDs are a valuable armamentarium in clinical medicine, but appropriate recognition of high-risk cases, selection of a specific agent, choice of ulcer prophylaxis and monitoring after therapy are necessary to minimise the risk of adverse events.

journal_name

Gut

journal_title

Gut

authors

Szeto CC,Sugano K,Wang JG,Fujimoto K,Whittle S,Modi GK,Chen CH,Park JB,Tam LS,Vareesangthip K,Tsoi KKF,Chan FKL

doi

10.1136/gutjnl-2019-319300

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

617-629

issue

4

eissn

0017-5749

issn

1468-3288

pii

gutjnl-2019-319300

journal_volume

69

pub_type

杂志文章,实务指引

相关文献

GUT文献大全
  • Role of intracellular Ca2+ and the calmodulin messenger system in pepsinogen secretion from isolated rabbit gastric mucosa.

    abstract::Both carbachol (10(-4)-10(-3) mol/l) and cholecystokinin octapeptide (CCK-8) (10(-8)-10(-6) mol/l) significantly stimulated the release of pepsinogen from rabbit gastric mucosa maintained in organ culture (213-216% and 143-261% of control, respectively, p less than 0.05-0.01). The secretion was not affected by removin...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.33.1.21

    authors: Miyamoto T,Itoh M,Noguchi Y,Yokochi K

    更新日期:1992-01-01 00:00:00

  • Computer aided positioning of manometric probe in the upper digestive tract.

    abstract::A method not needing fluoroscopic control for positioning a manometric probe in the gastroduodenal tract is described. It is based on hydrostatic pressure variations occurring at each recording port of a multichannel perfused probe after changes in patient's position. The data are fed into a computer and the schematic...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.29.7.1007

    authors: Bortolotti M,Bersani G

    更新日期:1988-07-01 00:00:00

  • Does treatment of Helicobacter pylori with antibiotics alone heal duodenal ulcer? A randomised double blind placebo controlled study.

    abstract:BACKGROUND:Treatment of Helicobacter pylori infection prevents duodenal ulcer relapse. It has not been established if treatment of the infection heals duodenal ulcer. AIM:To test the hypothesis that treatment of the infection was associated with healing of duodenal ulcer. METHODS:A randomised, double blind placebo co...

    journal_title:Gut

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/gut.41.1.43

    authors: Lam SK,Ching CK,Lai KC,Wong BC,Lai CL,Chan CK,Ong L

    更新日期:1997-07-01 00:00:00

  • Diverticulitis of the right colon--experience from Hong Kong.

    abstract::Diverticulitis affects the right side of the colon more commonly than the left side in the Far East. A consecutive series of 35 patients (mean age 44 years) with right sided diverticulitis seen at this hospital is presented. All had localised pain in the right iliac fossa but systemic upset was uncommon. All but one w...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.33.4.547

    authors: Markham NI,Li AK

    更新日期:1992-04-01 00:00:00

  • Qualitative and quantitative evaluation of internal anal sphincter function in the newborn.

    abstract::One-hundred-and-one normal neonates were examined manometrically in the first day of life to assess anorectal function. In order to overcome some of the difficulties in subjective interpretation of results, the stimuli used and the response pattern seen in the anal canal were measured. In the unstimulated state, all s...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.18.12.1036

    authors: Boston VE,Cywes S,Davies MR

    更新日期:1977-12-01 00:00:00

  • A clinical and histochemical study of cholestasis.

    abstract::A histochemical study of conjugated and total bilirubin was made on liver biopsies of 150 patients. Three types of cholestasis were defined: type I, characterized by the presence of intracellular pigment granules in the hepatocytes; type II, showing intracellular granules and extracellular thrombi (this group may be s...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.11.6.516

    authors: Desmet VJ,Bullens AM,De Groote J

    更新日期:1970-06-01 00:00:00

  • Chylous ascites, intestinal lymphangiectasia and the 'yellow-nail' syndrome.

    abstract::In 1964 Samman and White described 13 patients with lymphoedema of the lower extremities associated with an unusual dystrophy of the finger and toe nails: this they termed the 'yellow-nail' syndrome. Affected nails were thickened, excessively curved along both axes, very slow growing and of yellowish-grey hue; cuticle...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.26.11.1266

    authors: Duhra PM,Quigley EM,Marsh MN

    更新日期:1985-11-01 00:00:00

  • Comparison of the hepatic clearances of campesterol, sitosterol, and cholesterol in healthy subjects suggests that efflux transporters controlling intestinal sterol absorption also regulate biliary secretion.

    abstract:BACKGROUND:Recently identified ABCG5/8 transporters are responsible in part for the different absorption rates of campesterol, sitosterol, and cholesterol. These transporters are also expressed in the liver and might regulate biliary sterol secretion. AIMS:This study was therefore conducted to determine the biliary se...

    journal_title:Gut

    pub_type: 临床试验,杂志文章

    doi:10.1136/gut.51.6.860

    authors: Sudhop T,Sahin Y,Lindenthal B,Hahn C,Lüers C,Berthold HK,von Bergmann K

    更新日期:2002-12-01 00:00:00

  • Relationship between pancreatic secretion and pancreatic blood flow.

    abstract::An indicator fractionation technique using radioactive rubidium has been used to measure pancreatic blood flow after infusions of secretin, pancreozymin, urecholine, and pentagastrin. Secretin resulted in the production of a large volume of low viscous pancreatic juice and was associated with an increase in the cardia...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.11.1.62

    authors: Goodhead B,Himal HS,Zanbilowicz J

    更新日期:1970-01-01 00:00:00

  • Effect of alpha-glucosidehydrolase inhibition and intestinal absorption of sucrose, water, and sodium in man.

    abstract::The effect of a new complex oligosaccharide exhibiting potent inhibitory action on alpha-glucoside hydrolases on intestinal absorption of sucrose in man was tested by constant in vivo perfusion of the jejunum. At concentrations of 4.65 or 15.5 X 10(-6)M the alpha-glucosidehydrolase inhibitor (alpha-GHI) markedly inhib...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.20.9.750

    authors: Caspary WF,Kalisch H

    更新日期:1979-09-01 00:00:00

  • What does the antimitochondrial antibody mean?

    abstract::In a prospective survey positive antimitochondrial antibodies have been detected in 69/4200 (1.64%) of all sera submitted to a routine immunology laboratory. Of the 69, only nine patients had uniquivocal primary biliary cirrhosis, six others had chronic active hepatitis, 10 had abnormal liver function tests without ev...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.23.10.814

    authors: Triger DR,Charlton CA,Ward AM

    更新日期:1982-10-01 00:00:00

  • Validation of a specific quality of life questionnaire for functional digestive disorders.

    abstract:BACKGROUND:Dyspepsia and irritable bowel syndrome are suitable conditions for assessment of quality of life. Their similarities justify the elaboration of a single specific questionnaire for the two conditions. AIMS:To examine the process leading to the validation of the psychometric properties of the functional diges...

    journal_title:Gut

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/gut.44.4.527

    authors: Chassany O,Marquis P,Scherrer B,Read NW,Finger T,Bergmann JF,Fraitag B,Geneve J,Caulin C

    更新日期:1999-04-01 00:00:00

  • Age and Helicobacter pylori decrease gastric mucosal surface hydrophobicity independently.

    abstract:BACKGROUND:Gastric mucosal surface hydrophobicity (GMSH) is an essential component of the mucosal defence system that is decreased by Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Gastric ulcers occur predominantly in elderly subjects, and may thus reflect diminished mucosal resistance. AIMS:...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.43.4.465

    authors: Hackelsberger A,Platzer U,Nilius M,Schultze V,Günther T,Dominguez-Muñoz JE,Malfertheiner P

    更新日期:1998-10-01 00:00:00

  • IgG subclass distribution in serum and rectal mucosa of monozygotic twins with or without inflammatory bowel disease.

    abstract::Serum samples from 26 monozygotic twin pairs concordant or discordant with regard to inflammatory bowel disease, and rectal biopsies from 42 twins of the same subject group, were examined for IgG subclasses. They were all compared with normal controls. Almost all affected twins were in clinical remission. Paired immun...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.33.10.1358

    authors: Helgeland L,Tysk C,Järnerot G,Kett K,Lindberg E,Danielsson D,Andersen SN,Brandtzaeg P

    更新日期:1992-10-01 00:00:00

  • Effects of olsalazine and sulphasalazine on jejunal and ileal water and electrolyte absorption in normal human subjects.

    abstract::The effect of sulphasalazine and olsalazine on jejunal and ileal water and electrolyte absorption was investigated in normal subjects by a steady state intestinal perfusion of a physiological glucose bicarbonate electrolyte solution in the absence and presence of increasing concentrations of each drug. (Olsalazine 0.2...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.32.3.270

    authors: Raimundo AH,Patil DH,Frost PG,Silk DB

    更新日期:1991-03-01 00:00:00

  • Comparison of faecal bile acid profiles between patients with adenomatous polyps of the large bowel and healthy subjects in Japan.

    abstract::Faecal bile acid excretion was examined in 13 patients with adenomatous polyps of the large bowel and compared with a series of matched healthy subjects. Bile acids were analysed in detail with respect to the composition of individual bile acids and their mode of conjugation. The total excretion of bile acids by the p...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.25.8.824

    authors: Tanida N,Hikasa Y,Shimoyama T,Setchell KD

    更新日期:1984-08-01 00:00:00

  • Cytokine gene polymorphisms in inflammatory bowel disease.

    abstract:BACKGROUND:Concordance rates in siblings and twins provide strong evidence that genetic susceptibility is important in the pathogenesis of inflammatory bowel disease. The number and identity of susceptibility genes is largely uncertain. Cytokine genes are attractive candidate loci. AIMS:To study allelic frequencies of...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.39.5.705

    authors: Louis E,Satsangi J,Roussomoustakaki M,Parkes M,Fanning G,Welsh K,Jewell D

    更新日期:1996-11-01 00:00:00

  • The effects of corticotrophin and corticoids on secretion from denervated gastric pouches in dogs.

    abstract::The effects of corticotrophin and of cortisone, methyl prednisolone, and of aldosterone on the gastric secretion of dogs have been investigated. Juice was collected from dogs with denervated pouches under basal conditions and when stimulated with meat extract and with histamine. For each secretion the volume, viscosit...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.1.1.36

    authors: CLARKE SD,NEILL DW,WELBOURN RB

    更新日期:1960-03-01 00:00:00

  • Inflammatory gradient in Barrett's oesophagus: implications for disease complications.

    abstract:INTRODUCTION:Barrett's oesophageal epithelium (BE) is clinically important due to the associated inflammatory and malignant complications which are unevenly distributed throughout the BE segment. As the immunoregulatory environment may influence disease manifestations, we analysed the inflammatory and cytokine response...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.51.3.316

    authors: Fitzgerald RC,Abdalla S,Onwuegbusi BA,Sirieix P,Saeed IT,Burnham WR,Farthing MJ

    更新日期:2002-09-01 00:00:00

  • Relationship of hepatic iron concentration to histochemical grading and to total chelatable body iron in conditions associated with iron overload.

    abstract::A simple method based on atomic absorption spectrophotometry and using protein concentration as the reference standard was used for measuring the total tissue iron concentration in needle liver biopsy specimens from 47 patients with varying levels of body iron stores. The values obtained showed a close correlation ove...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.12.12.1011

    authors: Walker RJ,Miller JP,Dymock IW,Shilkin KB,Williams R

    更新日期:1971-12-01 00:00:00

  • Pancreatic alkaline phosphatase and a tumour variant.

    abstract::Alkaline phosphatase has been extracted from human pancreas with n-butanol and has been shown to have distinctive isoenzyme characteristics when compared with the enzymes of small intestine and of normal serum. The enzyme has been demonstrated histochemically in a carcinoma of the pancreas and also in an islet cell tu...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.13.7.513

    authors: Warnes TW,Timperley WR,Hine P,Kay G

    更新日期:1972-07-01 00:00:00

  • Assessment of variceal pressure by continuous non-invasive endoscopic registration: a placebo controlled evaluation of the effect of terlipressin and octreotide.

    abstract::Octreotide has been proposed for the treatment of variceal bleeding. The effects on portal pressure, however, have been variable in published studies. As bleeding is more directly related to pressure in the varices, this study investigated the effect on variceal pressure of octreotide and terlipressin, a vasoactive dr...

    journal_title:Gut

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/gut.38.1.129

    authors: Nevens F,Van Steenbergen W,Yap SH,Fevery J

    更新日期:1996-01-01 00:00:00

  • Sulforaphane targets pancreatic tumour-initiating cells by NF-kappaB-induced antiapoptotic signalling.

    abstract:BACKGROUND AND AIMS:Emerging evidence suggests that highly treatment-resistant tumour-initiating cells (TICs) play a central role in the pathogenesis of pancreatic cancer. Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) is considered to be a novel anticancer agent; however, recent studies have shown th...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.2008.149039

    authors: Kallifatidis G,Rausch V,Baumann B,Apel A,Beckermann BM,Groth A,Mattern J,Li Z,Kolb A,Moldenhauer G,Altevogt P,Wirth T,Werner J,Schemmer P,Büchler MW,Salnikov AV,Herr I

    更新日期:2009-07-01 00:00:00

  • The clinical and biological significance of MIR-224 expression in colorectal cancer metastasis.

    abstract:OBJECTIVE:MicroRNA (miRNA) expression profile can be used as prognostic marker for human cancers. We aim to explore the significance of miRNAs in colorectal cancer (CRC) metastasis. DESIGN:We performed miRNA microarrays using primary CRC tissues from patients with and without metastasis, and validated selected candida...

    journal_title:Gut

    pub_type: 杂志文章,多中心研究

    doi:10.1136/gutjnl-2015-309372

    authors: Ling H,Pickard K,Ivan C,Isella C,Ikuo M,Mitter R,Spizzo R,Bullock M,Braicu C,Pileczki V,Vincent K,Pichler M,Stiegelbauer V,Hoefler G,Almeida MI,Hsiao A,Zhang X,Primrose J,Packham G,Liu K,Bojja K,Gafà R,Xiao L

    更新日期:2016-06-01 00:00:00

  • Effect of monoclonal antibodies to enteroglucagon on ileal adaptation after proximal small bowel resection.

    abstract::On the basis of circumstantial clinical and experimental evidence, it has been suggested that enteroglucagon (EG) may act as an enterotrophic factor. This study was undertaken to evaluate the effects of long term in vivo immunoneutralisation of EG, using monoclonal antibodies to EG, on the hyperplastic ileal response ...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.28.suppl.9

    authors: Gregor M,Menge H,Stössel R,Riecken EO

    更新日期:1987-01-01 00:00:00

  • Effect of long-term treatment with cimetidine and antacids in Barrett's oesophagus.

    abstract::The effect of a long-term treatment (one to two years) with cimetidine (1.6 g per day) and an antacid (Regla pH) was evaluated in nine patients with a Barrett's oesophagus. The results showed that such long-term treatment had a beneficial effect on the symptoms and endoscopic signs of oesophagitis and on the healing o...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.22.9.724

    authors: Wesdorp IC,Bartelsman J,Schipper ME,Tytgat GN

    更新日期:1981-09-01 00:00:00

  • Histological assessment of the Sydney classification of endoscopic gastritis.

    abstract::To determine the significance of the endoscopic classification of gastritis proposed by a working party at the World Congress of Gastroenterology in Sydney 1990, 167 patients undergoing upper alimentary endoscopy were prospectively assessed by comprehensive endoscopic and histological methods. Ninety eight patients ha...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.35.9.1172

    authors: Khakoo SI,Lobo AJ,Shepherd NA,Wilkinson SP

    更新日期:1994-09-01 00:00:00

  • Caffeine protects against experimental acute pancreatitis by inhibition of inositol 1,4,5-trisphosphate receptor-mediated Ca2+ release.

    abstract:OBJECTIVE:Caffeine reduces toxic Ca2+ signals in pancreatic acinar cells via inhibition of inositol 1,4,5-trisphosphate receptor (IP3R)-mediated signalling, but effects of other xanthines have not been evaluated, nor effects of xanthines on experimental acute pancreatitis (AP). We have determined effects of caffeine an...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gutjnl-2015-309363

    authors: Huang W,Cane MC,Mukherjee R,Szatmary P,Zhang X,Elliott V,Ouyang Y,Chvanov M,Latawiec D,Wen L,Booth DM,Haynes AC,Petersen OH,Tepikin AV,Criddle DN,Sutton R

    更新日期:2017-02-01 00:00:00

  • Real time high resolution magnetic resonance imaging for the assessment of gastric motility disorders.

    abstract:BACKGROUND:The aim of this study was to evaluate whether patients with increased or decreased gastric motility can be differentiated from healthy volunteers by means of real time magnetic resonance imaging (MRI). PATIENTS AND METHODS:Ten healthy volunteers, 10 patients with gastroparesis, and 10 patients with function...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.2003.038588

    authors: Ajaj W,Goehde SC,Papanikolaou N,Holtmann G,Ruehm SG,Debatin JF,Lauenstein TC

    更新日期:2004-09-01 00:00:00

  • Lymphocyte subpopulations in adult coeliac disease.

    abstract::Rosetting techniques were used to estimate T and B cell subpopulations in the peripheral blood in patients with treated and untreated adult coeliac disease and in control subjects. In patients with untreated coeliac disease, T cell numbers were significantly lower than in controls or treated patients, although there w...

    journal_title:Gut

    pub_type: 杂志文章

    doi:10.1136/gut.19.10.892

    authors: Bullen AW,Losowsky MS

    更新日期:1978-10-01 00:00:00