In High-Risk Patients, Adding a PPI to Celecoxib Improves GI Safety

In a randomized trial, there was no recurrence of upper GI ulcer bleeding among those whose regimens included a PPI.

For patients at the highest risk for upper gastrointestinal bleeding — those who have previously had bleeding ulcers — current pain control guidelines recommend either a cyclooxygenase-2 inhibitor or the combination of a nonselective nonsteroidal anti-inflammatory drug (NSAID) and a proton-pump inhibitor (PPI). But about 5% of high-risk patients on either of these regimens bleed again.

To test whether the combination of a COX-2 inhibitor and a PPI may be safer, investigators studied 273 patients with arthritis and NSAID-related, endoscopically proved upper GI ulcer bleeding. Endoscopy showed that all ulcers healed completely after PPI therapy; all patients were free of Helicobacter pylori infection (either initially or after treatment) and r…

Reviewing Author

Bruce Soloway, MD

In High-Risk Patients, Adding a PPI to Celecoxib Improves GI Safety

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Reviewing Author