PROPHYLAXIS OF NSAID ASSOCIATED GASTRODUODENAL DAMAGE - A CRITICAL-REVIEW OF RISK-FACTORS

Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a si gnificant morbidity and mortality, not because they are particularly d angerous drugs but because they are so commonly prescribed. In epidemi ologic terms the problem is characterized by a high level of the risk factor (NSAID use) rather than a high risk of complications. The risk in any individual patient depends on age, concomitant conditions and m edications, dose of NSAID, and duration of treatment. There is no evid ence that prophylactic therapy decreases the risk of clinically import ant events such as hemorrhage. Prophylactic therapy has been shown to prevent endoscopic signs of gastroduodenal damage and should be used i n high risk patients pending proof of clinically relevant efficacy.