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
2011 Impact Factor: 3.769
2011 SCImago Journal Rankings: 0.338
DOIhttp://dx.doi.org/10.1111/j.1365-2036.2004.01857.x
ISI Accession Number IDWOS:000220090400014
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 3.769
2011 SCImago Journal Rankings: 0.338
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
Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong