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Low-dose aspirin therapy is associated with an increased risk for peptic ulcer disease. In studies of Western populations, proton-pump inhibitors (PPIs) have been shown to reduce this risk. However, physiologic differences between Western and East Asian populations — including the rate of polymorphisms of cytochrome P450 enzymes that metabolize PPIs — might result in variable efficacy.
To assess the efficacy of PPIs to prevent ulcer recurrence in an East Asian population, researchers randomized 364 patients at 57 locations in Japan, Korea, and Taiwan to receive esomeprazole (20 mg/day) or placebo in a double-blind study. All patients had endoscopic documentation of past peptic ulcer disease and were currently taking low-dose aspirin (81–324 …