NSAIDs gastropathies in clinician’s practice

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Abstract

Current review presents current information about risk factors, epidemiology of NSAIDs gastropathy in Russia and throughout the world, and provides a comparative description of nonsteroidal anti-inflammatory drugs (NSAID) in terms of the incidence of this complication and their influence at the digestive tract. Peculiarities of outpatients with NSAIDS gastropathy are covered, and the algorithm for managing such patients is discussed in details using a clinical case as an example.

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About the authors

Igor G. Bakulin

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: igbakulin@yandex.ru
ORCID iD: 0000-0002-6151-2021

MD, Dr. Sci. (Medicine), professor, head of the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

Elena B. Avalueva

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: avalueva@mail.ru
ORCID iD: 0000-0001-6011-0998

MD, Dr. Sci. (Medicine), professor of the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

Natalya V. Bakulina

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: nv_bakulina@mail.ru
ORCID iD: 0000-0003-4075-4096

MD, Dr. Sci. (Medicine), professor, head of the Department of internal medicine, nephrology, general and clinical pharmacology with a pharmacy course

Russian Federation, Saint Petersburg

Margarita Yu. Serkova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: serkova.margarita@yandex.ru
ORCID iD: 0000-0001-9600-3131

MD, PhD (Medicine), assistant at the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

Dmitry G. Berest

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: berestdg@mail.ru

MD, PhD (Medicine), associate professor of the Department of faculty surgery with a course of endoscopy named after I.I. Grekov, head of the Department of endoscopy of the Hospital named after Peter the Great

Russian Federation, Saint Petersburg

Elena Yu. Pavlova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: epavlova.doc@mail.ru

MD, PhD (Medicine), assistant at the Department of propaedeutics of internal diseases, gastroenterology and dietetics named after S.M. Ryss

Russian Federation, Saint Petersburg

References

  1. Каратеев А.Е., Насонов Е.Л., Ивашкин В.Т. с соавт. Рациональное использование нестероидных противовоспалительных препаратов. Клинические рекомендации. Научно-практическая ревматология. 2018; 56(S1): 1–29. [Karateev A.E., Nasonov E.L., Ivashkin V.T. et al. Rational use of nonsteroidal anti-inflammatory drugs. Clinical guidelines. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2018; 56(S1): 1–29 (In Russ.)]. https://doi.org/10.14412/rjtao20180. EDN: PCPKRP.
  2. Аналитический отчет DSM Group. Итоги 2022 года: аптечный сегмент лекарственных препаратов. Доступ: https://dsm.ru/docs/analytics/Annual_report_2023_rus.pdf (дата обращения – 04.04.2024). [Analytical report of DSM Group. Results of 2022: Pharmaceutical segment of medicines. URL: https://dsm.ru/docs/analytics/Annual_report_2023_rus.pdf (date of access – 04.04.2024) (In Russ.)].
  3. Циммерман Я.С. Поражение желудка, индуцированное приемом нестероидных противовоспалительных препаратов (НПВП): НПВП-гастрит или НПВП-гастропатия? Клиническая фармакология и терапия. 2018; 27(1): 14–21. [Tsimmerman Ya.S. Gastric damage induced by nonsteroidal anti-inflammatory drugs (NSAIDs): NSAID gastritis or NSAID gastropathy? Klinicheskaya farmakologiya i terapiya = Clinical Pharmacology and Therapy. 2018; 27(1): 14–21 (In Russ.)]. EDN: YVJSHS.
  4. Маев И.В., Андреев Д.Н., Дичева Д.Т. Гастропатии, индуцированные нестероидными противовоспалительными средствами: патогенетически обусловленные подходы к профилактике и терапии. Фарматека. 2016; (2): 49–54. [Maev I.V., Andreev D.N., Dicheva D.T. NSAID-induced gastropathies: Pathogenetically substantiated approaches to prevention and therapy. Farmateka. 2016; (2): 49–54 (In Russ.)]. EDN: VMICOR.
  5. Lanza F.L., Chan F.K.., Quigley E.M. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009; 104: 728–38. https://doi.org/10.1038/ajg.2009.115. PMID: 19240698.
  6. 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): 241–49. https://doi.org/10.7326/0003-4819-123-4-199508150-00001. PMID: 7611589.
  7. Насонов Е.Л., Каратеев А.Е. Поражения желудка, связанные с приемом нестероидных противовоспалительных препаратов. Клиническая медицина. 2000; 78(3): 4–10. [Nasonov E.L., Karateev A.E. Gastric lesions associated with non-steroidal anti-inflammatory drugs. Klinicheskaya meditsina = Clinical Medicine. 2000; 78(3): 4–10 (In Russ.)]. EDN: GPBVBT.
  8. Dequerker J., Hawkey C., Kahan A. et al. Improvement in gastrointestinal tolerability of selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Large Scale Evaluation of COX inhibiting Therapies (SELECT) trial in osteoarthritis. Br J Rheumatol. 1998; 37(9): 946–51. https://doi.org/10.1093/rheumatology/37.9.946. PMID: 9783758.
  9. Stam W., Jansen J., Taylor S. Efficacy of etoricoxib, celecoxib, lumiracoxib, non-selective NSAIDs, and acetaminophen in osteoarthritis: A mixed treatment comparison. Open Rheumatol J. 2012; 6: 6–20. https://doi.org/10.2174/1874312901206010006. PMID: 22582102. PMCID: PMC3349945.
  10. Yang M., Wang H.T., Zhao M. et al. Network meta-analysis comparing relatively selective COX-2 inhibitors versus coxibs for the prevention of NSAID-induced gastrointestinal injury. Medicine (Baltimore). 2015; 94(40): e1592. https://doi.org/10.1097/MD.0000000000001592. PMID: 26448006. PMCID: PMC4616749.
  11. Каратеев А.Е. Российский опыт применения нимесулида: обзор клинических испытаний. Consilium Medicum. 2011; 13(9): 89–95. [Karateev A.E. Russian experience with nimesulide: Review of clinical trials. Consilium Medicum. 2011; 13(9): 89–95 (In Russ.)]. EDN: RASPJZ.
  12. Каратеев А.Е., Цурган А.В. Ацеклофенак: опыт российских исследований. Современная ревматология. 2017; 11(4): 89–94. [Karateev A.E., Tsurgan A.V. Aceclofenac: The experience of Russian studies. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2017; 11(4): 89–94 (In Russ.)]. https://doi.org/10.14412/1996-7012-2017-4-89-94. EDN: ZXYAHP.
  13. Chan F.K., 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(9736): 173–79. https://doi.org/10.1016/S0140-6736(10)60673. PMID: 20638563.
  14. Conforti A., Leone R., Moretti U. et al. Adverse drug reactions related to the use of NSAIDs with a focus on nimesulide: Results of spontaneous reporting from a Northern Italian area. Drug Saf. 2001; 24(14): 1081–90. https://doi.org/10.2165/00002018-200124140-00006. PMID: 11735663.
  15. Feng X., Tian M., Zhang W., Mei H. Gastrointestinal safety of etoricoxib in osteoarthritis and rheumatoid arthritis: A meta-analysis. PLoS One. 2018; 13(1): e0190798. https://doi.org/10.1371/journal.pone.0190798. PMID: 29320568. PMCID: PMC5761870.
  16. Захарова Н.В., Бакулин И.Г., Симаненков В.И., Маслыгина А.А. Обзор рекомендаций пятого Маастрихтского/Флорентийского консенсуса по диагностике и лечению инфекции Helicobacter pylori. Фарматека. 2016; (S5): 8–26. [Zakharova N.V., Bakulin I.G., Simanenkov V.I., Maslygina A.A. Review of the Maastricht V / Florence consensus recommendations on the diagnosis and treatment of Helicobacter pylori infection. Farmateka. 2016; (S5): 8–26 (In Russ.)]. EDN: XSDFXR.
  17. Laine L., Curtis S.P., Cryer B. et al. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: A randomised comparison. Lancet. 2007; 369(9560): 465–73. https://doi.org/10.1016/S0140-6736(07)60234-7. PMID: 17292766.
  18. Laine L., Curtis S.P., Langman M. et al. Lower gastrointestinal events in a double-blind trial of the cyclo-oxygenase-2 selective inhibitor etoricoxib and the traditional nonsteroidal anti-inflammatory drug diclofenac. Gastroenterology. 2008; 135(5): 1517–25. https://doi.org/10.1053/j.gastro.2008.07.067. PMID: 18823986.
  19. Garg A., Shoeb A., Moodahadu L.S. et al. Amtolmetin: A reappraisal of NSAID with gastroprotection. Arthritis. 2016; 2016: 7103705. https://doi.org/10.1155/2016/7103705. PMID: 27092274. PMCID: PMC4820613.
  20. Трухан Д.И. Нестероидные противовоспалительные препараты сквозь призму коморбидности и лекарственной безопасности: в фокусе – амтолметин гуацил. Consilium Medicum. 2015; 17(2): 27–33. [Trukhan D.I. Nonsteroidal anti-inflammatory drugs through the prism comorbidity and drug safety: In focus amtolmetin guatsil. Consilium Medicum. 2015; 17(2): 27–33 (In Russ.)]. EDN: TVLTCH.
  21. 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. https://doi.org/10.2165/11633470-000000000-00000.
  22. Морозова Т.Е., Рыкова С.М., Чукина М.А. НПВП-гастропатии у больных с сочетанной патологией сердечно-сосудистой системы и заболеваниями суставов и позвоночника. Экспериментальная и клиническая гастроэнтерология. 2015; (6): 64–70. [Morozova T.E., Rykova S.M., Chukina M.A. NSAID gastropathy in patients with comorbid diseases. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2015; (6): 64–70 (In Russ.)]. EDN: UHYNMD.
  23. Шостак Н.А., Рябкова А.А., Савельев В.С., Малярова Л.П. Желудочно-кишечные кровотечения, как осложнение гастропатий, связанных с приемом НПВП. Терапевтический архив. 2003; 75(5): 70–73. [Shostak N.A., Ryabkova A.A., Savelyev V.S., Malyarova L.P. Gastrointestinal hemorrhages as complications of gastropathies associated with intake of non-steroid anti-inflammatory drugs. Terapevticheskiy arkhiv = Therapeutic Archive. 2003; 75(5): 70–73 (In Russ.)]. EDN: OJZQIH.
  24. Захарова Н.В., Симаненков В.И., Бакулин И.Г. с соавт. Распространенность хеликобактерной инфекции у пациентов гастроэнтерологического профиля в Санкт-Петербурге. Фарматека. 2016; (S5): 33–39. [Zakharova N.V., Simanenkov V.I., Bakulin I.G. et al. Prevalence of Helicobacter pylori infection in gastroenterological patients in Saint Petersburg. Farmateka. 2016; (S5): 33–39 (In Russ.)]. EDN: XSDGAJ.

Supplementary files

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2. Fig. 1. Single hemorrhage against the background of erythematous gastropathy (body of the stomach)

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3. Fig. 2. Multiple erosions in the stomach against the background of erythematous gastropathy

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4. Fig. 3. A - multiple erosive hemorrhages on the crest of the longitudinal fold of the body of the stomach, traces of barium sulfate are visible in the lumen; B - the same patient after removal of barium sulfate, signs of bleeding from erosion are visible

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5. Fig. 4. A - multiple erosions in the body of the stomach; B - the same patient, photo in NBI mode

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6. Fig. 5. NSAID-gastropathy against the background of H. pyfori-associated gastritis

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7. Fig. 6. Small erosions in the healing stage against the background of taking proton pump inhibitors and rebamipide

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8. Fig. 7. Hemorrhagic gastropathy in the antral section with signs of bleeding

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9. Fig. 8. Erythematous gastropathy without a hemorrhagic component (regression of elements against the background of taking proton pump inhibitors and rebamipide), the integrity of the integumentary epithelium is preserved, but intramucosal flat hemorrhages are visible

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