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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

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
Authors
Issue Date2004
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
Citation
Alimentary Pharmacology And Therapeutics, 2004, v. 19 n. 3, p. 359-365 How to Cite?
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 ± 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.
Persistent Identifierhttp://hdl.handle.net/10722/162785
ISSN
2013 Impact Factor: 5.478
2013 SCImago Journal Rankings: 2.609
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNg, FHen_US
dc.contributor.authorWong, BCYen_US
dc.contributor.authorWong, SYen_US
dc.contributor.authorChen, WHen_US
dc.contributor.authorChang, CMen_US
dc.date.accessioned2012-09-05T05:23:29Z-
dc.date.available2012-09-05T05:23:29Z-
dc.date.issued2004en_US
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2004, v. 19 n. 3, p. 359-365en_US
dc.identifier.issn0269-2813en_US
dc.identifier.urihttp://hdl.handle.net/10722/162785-
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.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APTen_US
dc.relation.ispartofAlimentary Pharmacology and Therapeuticsen_US
dc.rightsAlimentary Pharmacology and Therapeutics. Copyright © Blackwell Publishing Ltd.-
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAnti-Ulcer Agents - Administration & Dosageen_US
dc.subject.meshAspirin - Administration & Dosage - Adverse Effectsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOmeprazole - Administration & Dosageen_US
dc.subject.meshPeptic Ulcer - Chemically Induced - Drug Therapyen_US
dc.subject.meshPeptic Ulcer Hemorrhage - Chemically Induced - Drug Therapyen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSingle-Blind Methoden_US
dc.subject.meshTiclopidine - Administration & Dosage - Analogs & Derivativesen_US
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 studyen_US
dc.typeArticleen_US
dc.identifier.emailWong, BCY:bcywong@hku.hken_US
dc.identifier.authorityWong, BCY=rp00429en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1365-2036.2004.01857.xen_US
dc.identifier.pmid14984383en_US
dc.identifier.scopuseid_2-s2.0-1342331532en_US
dc.identifier.hkuros86282-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1342331532&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume19en_US
dc.identifier.issue3en_US
dc.identifier.spage359en_US
dc.identifier.epage365en_US
dc.identifier.isiWOS:000220090400014-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridNg, FH=16936078000en_US
dc.identifier.scopusauthoridWong, BCY=7402023340en_US
dc.identifier.scopusauthoridWong, SY=7404590959en_US
dc.identifier.scopusauthoridChen, WH=7409637978en_US
dc.identifier.scopusauthoridChang, CM=7407031960en_US

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