File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Celecoxib compared with lansoprazole and naproxen to prevent gastrointestinal ulcer complications

TitleCelecoxib compared with lansoprazole and naproxen to prevent gastrointestinal ulcer complications
Authors
KeywordsCelecoxib
Lansoprazole
NSAIDs
Ulcers
Issue Date2005
PublisherExcerpta Medica, Inc. The Journal's web site is located at http://www.elsevier.com/locate/amj
Citation
American Journal Of Medicine, 2005, v. 118 n. 11, p. 1271-1278 How to Cite?
AbstractPURPOSE: Selective cyclooxygenase-2 (COX-2) inhibitors cause significantly fewer peptic ulcers than conventional nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) in patients at low risk or high risk for peptic ulcers. On the other hand, proton pump inhibitor co-therapy has also been shown to be effective in preventing relapse of peptic ulcers in high-risk patients using nonselective NSAIDs. We compared the efficacy of a selective COX-2 inhibitor with that of proton pump inhibitor co-therapy in the reduction in the incidence of ulcer relapse in patients with a history of NSAID-related peptic ulcers. MATERIALS AND METHODS: For this study, we recruited 224 patients who developed ulcer complications after NSAID use. We excluded patients who required concomitant aspirin treatment and who had renal impairment. After healing of ulcers and eradication of Helicobacter pylori, patients were randomly assigned to treatment with celecoxib 200 mg daily (n = 120) or naproxen 750 mg daily and lansoprazole 30 mg daily (n = 122) for 24 weeks. The primary endpoint was recurrent ulcer complications. RESULTS: During a median follow-up of 24 weeks, 4 (3.7%, 95% confidence interval [CI] 0.0%-7.3%) patients in the celecoxib group, compared with 7 patients (6.3%, 95% CI 1.6%-11.1%) in the lansoprazole group, developed recurrent ulcer complications (absolute difference -2.6%; 95% CI for the difference -9.1%-3.7%). Celecoxib was statistically non-inferior to lansoprazole co-therapy in the prevention of recurrent ulcer complications. Concomitant illness (hazard ratio 4.72, 95% CI 1.24-18.18) and age 65 years or more (hazard ratio 18.52, 95% CI 2.26-142.86) were independent risk factors for ulcer recurrences. Significantly more patients receiving celecoxib (15.0%, 95% CI 9.7-22.5) developed dyspepsia than patients receiving lansoprazole (5.7%, 95% CI 2.8-11.4. P = .02). CONCLUSIONS: Celecoxib was as effective as lansoprazole co-therapy in the prevention of recurrences of ulcer complications in subjects with a history of NSAID-related complicated peptic ulcers. However, celecoxib, similar to lansoprazole co-therapy, was still associated with a significant proportion of ulcer complication recurrences. In addition, more patients receiving celecoxib developed dyspepsia than patients receiving lansoprazole and naproxen. © 2005 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/162897
ISSN
2015 Impact Factor: 5.61
2015 SCImago Journal Rankings: 2.023
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLai, KCen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorHui, WMen_HK
dc.contributor.authorWong, BCYen_HK
dc.contributor.authorHu, WHCen_HK
dc.contributor.authorWong, WMen_HK
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorWong, Jen_HK
dc.contributor.authorLam, SKen_HK
dc.date.accessioned2012-09-05T05:25:00Z-
dc.date.available2012-09-05T05:25:00Z-
dc.date.issued2005en_HK
dc.identifier.citationAmerican Journal Of Medicine, 2005, v. 118 n. 11, p. 1271-1278en_HK
dc.identifier.issn0002-9343en_HK
dc.identifier.urihttp://hdl.handle.net/10722/162897-
dc.description.abstractPURPOSE: Selective cyclooxygenase-2 (COX-2) inhibitors cause significantly fewer peptic ulcers than conventional nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) in patients at low risk or high risk for peptic ulcers. On the other hand, proton pump inhibitor co-therapy has also been shown to be effective in preventing relapse of peptic ulcers in high-risk patients using nonselective NSAIDs. We compared the efficacy of a selective COX-2 inhibitor with that of proton pump inhibitor co-therapy in the reduction in the incidence of ulcer relapse in patients with a history of NSAID-related peptic ulcers. MATERIALS AND METHODS: For this study, we recruited 224 patients who developed ulcer complications after NSAID use. We excluded patients who required concomitant aspirin treatment and who had renal impairment. After healing of ulcers and eradication of Helicobacter pylori, patients were randomly assigned to treatment with celecoxib 200 mg daily (n = 120) or naproxen 750 mg daily and lansoprazole 30 mg daily (n = 122) for 24 weeks. The primary endpoint was recurrent ulcer complications. RESULTS: During a median follow-up of 24 weeks, 4 (3.7%, 95% confidence interval [CI] 0.0%-7.3%) patients in the celecoxib group, compared with 7 patients (6.3%, 95% CI 1.6%-11.1%) in the lansoprazole group, developed recurrent ulcer complications (absolute difference -2.6%; 95% CI for the difference -9.1%-3.7%). Celecoxib was statistically non-inferior to lansoprazole co-therapy in the prevention of recurrent ulcer complications. Concomitant illness (hazard ratio 4.72, 95% CI 1.24-18.18) and age 65 years or more (hazard ratio 18.52, 95% CI 2.26-142.86) were independent risk factors for ulcer recurrences. Significantly more patients receiving celecoxib (15.0%, 95% CI 9.7-22.5) developed dyspepsia than patients receiving lansoprazole (5.7%, 95% CI 2.8-11.4. P = .02). CONCLUSIONS: Celecoxib was as effective as lansoprazole co-therapy in the prevention of recurrences of ulcer complications in subjects with a history of NSAID-related complicated peptic ulcers. However, celecoxib, similar to lansoprazole co-therapy, was still associated with a significant proportion of ulcer complication recurrences. In addition, more patients receiving celecoxib developed dyspepsia than patients receiving lansoprazole and naproxen. © 2005 Elsevier Inc. All rights reserved.en_HK
dc.languageengen_US
dc.publisherExcerpta Medica, Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjen_HK
dc.relation.ispartofAmerican Journal of Medicineen_HK
dc.subjectCelecoxiben_HK
dc.subjectLansoprazoleen_HK
dc.subjectNSAIDsen_HK
dc.subjectUlcersen_HK
dc.subject.mesh2-Pyridinylmethylsulfinylbenzimidazolesen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshAnti-Ulcer Agents - Administration & Dosage - Therapeutic Useen_US
dc.subject.meshCyclooxygenase 2 Inhibitors - Adverse Effects - Therapeutic Useen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshDyspepsia - Chemically Induceden_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHelicobacter Infections - Drug Therapyen_US
dc.subject.meshHelicobacter Pylorien_US
dc.subject.meshHumansen_US
dc.subject.meshIncidenceen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNaproxen - Administration & Dosage - Adverse Effects - Therapeutic Useen_US
dc.subject.meshOmeprazole - Administration & Dosage - Analogs & Derivatives - Therapeutic Useen_US
dc.subject.meshPeptic Ulcer - Chemically Induced - Epidemiology - Prevention & Controlen_US
dc.subject.meshPeptic Ulcer Hemorrhage - Chemically Induceden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshProton Pumps - Antagonists & Inhibitorsen_US
dc.subject.meshPyrazoles - Adverse Effects - Therapeutic Useen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSulfonamides - Adverse Effects - Therapeutic Useen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleCelecoxib compared with lansoprazole and naproxen to prevent gastrointestinal ulcer complicationsen_HK
dc.typeArticleen_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailWong, BCY: bcywong@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.amjmed.2005.04.031en_HK
dc.identifier.pmid16271912-
dc.identifier.scopuseid_2-s2.0-27644531878en_HK
dc.identifier.hkuros111296-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27644531878&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume118en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1271en_HK
dc.identifier.epage1278en_HK
dc.identifier.isiWOS:000233123000016-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLai, KC=7402135595en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridHui, WM=7103196477en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK
dc.identifier.scopusauthoridHu, WHC=25932937100en_HK
dc.identifier.scopusauthoridWong, WM=7403972413en_HK
dc.identifier.scopusauthoridChan, AOO=7403167965en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.scopusauthoridLam, SK=7402279800en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats