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Article: Clopidogrel plus omeprazole compared with aspirin plus omeprazole for aspirin-induced symptomatic peptic ulcers/erosions with low to moderate bleeding/re-bleeding risk - A single-blind, randomized controlled study
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TitleClopidogrel plus omeprazole compared with aspirin plus omeprazole for aspirin-induced symptomatic peptic ulcers/erosions with low to moderate bleeding/re-bleeding risk - A single-blind, randomized controlled study
 
AuthorsNg, FH2
Wong, BCY1
Wong, SY2
Chen, WH1
Chang, CM2
 
Issue Date2004
 
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
 
CitationAlimentary Pharmacology And Therapeutics, 2004, v. 19 n. 3, p. 359-365 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1365-2036.2004.01857.x
 
AbstractBackground: Clopidogrel causes significantly less symptomatic peptic ulcer disease and gastrointestinal bleeding than low-dose aspirin in average-risk patients. The gastrotoxicity of clopidogrel in patients with active peptic ulcer disease is unknown. Aim: To compare the incidence of unhealed ulcers in patients receiving clopidogrel or aspirin. Methods: Patients with aspirin-induced peptic ulcer disease treated with omeprazole (20 mg/day) were randomized to receive clopidogrel (75 mg/day) or to continue with low-dose aspirin. Success was defined as ulcer/erosion healing at the eighth week. Results: One hundred and twenty-nine patients were recruited (69 received clopidogrel and 60 continued with aspirin). Thirty-one (45%) in the clopidogrel group and 25 (42%) in the aspirin group had a minor gastrointestinal bleed. No ulcer showed an adherent clot or visible vessel. The distributions of peptic ulcer disease were similar in the clopidogrel and aspirin groups (gastric ulcer: 41% vs. 40%; duodenal ulcer: 10% vs. 12%; gastric ulcer + duodenal ulcer: 6% vs. 3%; gastritis: 32% vs. 37%; duodenitis: 4% vs. 7%; gastritis + duodenitis: 0% vs. 2%). Clopidogrel and aspirin were re-started after 0.86 ± 1.79 and 0.44 ± 1.60 days, respectively (P = 0.170). Three (4%) patients stopped clopidogrel due to drug rash. Using per protocol analysis, the treatment success rates of clopidogrel and aspirin were 94% (62/66) and 95% (57/60), respectively. Conclusions: In patients with aspirin-associated peptic ulcer disease of low to moderate grade, both early conversion from aspirin to clopidogrel and continuation of aspirin are safe.
 
ISSN0269-2813
2012 Impact Factor: 4.548
2012 SCImago Journal Rankings: 1.689
 
DOIhttp://dx.doi.org/10.1111/j.1365-2036.2004.01857.x
 
ISI Accession Number IDWOS:000220090400014
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorNg, FH
 
dc.contributor.authorWong, BCY
 
dc.contributor.authorWong, SY
 
dc.contributor.authorChen, WH
 
dc.contributor.authorChang, CM
 
dc.date.accessioned2012-09-05T05:23:29Z
 
dc.date.available2012-09-05T05:23:29Z
 
dc.date.issued2004
 
dc.description.abstractBackground: Clopidogrel causes significantly less symptomatic peptic ulcer disease and gastrointestinal bleeding than low-dose aspirin in average-risk patients. The gastrotoxicity of clopidogrel in patients with active peptic ulcer disease is unknown. Aim: To compare the incidence of unhealed ulcers in patients receiving clopidogrel or aspirin. Methods: Patients with aspirin-induced peptic ulcer disease treated with omeprazole (20 mg/day) were randomized to receive clopidogrel (75 mg/day) or to continue with low-dose aspirin. Success was defined as ulcer/erosion healing at the eighth week. Results: One hundred and twenty-nine patients were recruited (69 received clopidogrel and 60 continued with aspirin). Thirty-one (45%) in the clopidogrel group and 25 (42%) in the aspirin group had a minor gastrointestinal bleed. No ulcer showed an adherent clot or visible vessel. The distributions of peptic ulcer disease were similar in the clopidogrel and aspirin groups (gastric ulcer: 41% vs. 40%; duodenal ulcer: 10% vs. 12%; gastric ulcer + duodenal ulcer: 6% vs. 3%; gastritis: 32% vs. 37%; duodenitis: 4% vs. 7%; gastritis + duodenitis: 0% vs. 2%). Clopidogrel and aspirin were re-started after 0.86 ± 1.79 and 0.44 ± 1.60 days, respectively (P = 0.170). Three (4%) patients stopped clopidogrel due to drug rash. Using per protocol analysis, the treatment success rates of clopidogrel and aspirin were 94% (62/66) and 95% (57/60), respectively. Conclusions: In patients with aspirin-associated peptic ulcer disease of low to moderate grade, both early conversion from aspirin to clopidogrel and continuation of aspirin are safe.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2004, v. 19 n. 3, p. 359-365 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1365-2036.2004.01857.x
 
dc.identifier.doihttp://dx.doi.org/10.1111/j.1365-2036.2004.01857.x
 
dc.identifier.epage365
 
dc.identifier.hkuros86282
 
dc.identifier.isiWOS:000220090400014
 
dc.identifier.issn0269-2813
2012 Impact Factor: 4.548
2012 SCImago Journal Rankings: 1.689
 
dc.identifier.issue3
 
dc.identifier.pmid14984383
 
dc.identifier.scopuseid_2-s2.0-1342331532
 
dc.identifier.spage359
 
dc.identifier.urihttp://hdl.handle.net/10722/162785
 
dc.identifier.volume19
 
dc.languageeng
 
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofAlimentary Pharmacology and Therapeutics
 
dc.relation.referencesReferences in Scopus
 
dc.rightsAlimentary Pharmacology and Therapeutics. Copyright © Blackwell Publishing Ltd.
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 And Over
 
dc.subject.meshAnti-Ulcer Agents - Administration & Dosage
 
dc.subject.meshAspirin - Administration & Dosage - Adverse Effects
 
dc.subject.meshFemale
 
dc.subject.meshHumans
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshOmeprazole - Administration & Dosage
 
dc.subject.meshPeptic Ulcer - Chemically Induced - Drug Therapy
 
dc.subject.meshPeptic Ulcer Hemorrhage - Chemically Induced - Drug Therapy
 
dc.subject.meshRisk Factors
 
dc.subject.meshSingle-Blind Method
 
dc.subject.meshTiclopidine - Administration & Dosage - Analogs & Derivatives
 
dc.titleClopidogrel plus omeprazole compared with aspirin plus omeprazole for aspirin-induced symptomatic peptic ulcers/erosions with low to moderate bleeding/re-bleeding risk - A single-blind, randomized controlled study
 
dc.typeArticle
 
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<contributor.author>Chen, WH</contributor.author>
<contributor.author>Chang, CM</contributor.author>
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<description.abstract>Background: Clopidogrel causes significantly less symptomatic peptic ulcer disease and gastrointestinal bleeding than low-dose aspirin in average-risk patients. The gastrotoxicity of clopidogrel in patients with active peptic ulcer disease is unknown. Aim: To compare the incidence of unhealed ulcers in patients receiving clopidogrel or aspirin. Methods: Patients with aspirin-induced peptic ulcer disease treated with omeprazole (20 mg/day) were randomized to receive clopidogrel (75 mg/day) or to continue with low-dose aspirin. Success was defined as ulcer/erosion healing at the eighth week. Results: One hundred and twenty-nine patients were recruited (69 received clopidogrel and 60 continued with aspirin). Thirty-one (45%) in the clopidogrel group and 25 (42%) in the aspirin group had a minor gastrointestinal bleed. No ulcer showed an adherent clot or visible vessel. The distributions of peptic ulcer disease were similar in the clopidogrel and aspirin groups (gastric ulcer: 41% vs. 40%; duodenal ulcer: 10% vs. 12%; gastric ulcer + duodenal ulcer: 6% vs. 3%; gastritis: 32% vs. 37%; duodenitis: 4% vs. 7%; gastritis + duodenitis: 0% vs. 2%). Clopidogrel and aspirin were re-started after 0.86 &#177; 1.79 and 0.44 &#177; 1.60 days, respectively (P = 0.170). Three (4%) patients stopped clopidogrel due to drug rash. Using per protocol analysis, the treatment success rates of clopidogrel and aspirin were 94% (62/66) and 95% (57/60), respectively. Conclusions: In patients with aspirin-associated peptic ulcer disease of low to moderate grade, both early conversion from aspirin to clopidogrel and continuation of aspirin are safe.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong