Do PPIs Reduce Ulcer Risk in Elderly Users of NSAIDs or Aspirin?

Use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk for gastroduodenal ulcers. Results from prospective randomized trials demonstrate that concomitant use of a proton-pump inhibitor (PPI) or misoprostol can reduce this risk. Investigators in Italy examined the effect of PPI therapy on ulcer occurrence in 3111 consecutive elderly (65 or older) NSAID or aspirin users who presented for outpatient upper GI endoscopy. Prior users of aspirin, NSAIDs, PPIs, and H₂-blockers were identified using a structured interview. Endoscopic findings, histology, and Helicobacter pylori infection status were assessed for each patient.

Researchers identified 676 patients who had used aspirin or NSAIDS within 7 days before endoscopy…