Gastroprotective Drugs to Prevent NSAID Complications: A Comparison

Multiple approaches have been suggested to reduce the risk for gastrointestinal bleeding and peptic ulcer disease from nonsteroidal anti-inflammatory drugs (NSAIDs).

To compare the effectiveness of such strategies, investigators performed a network meta-analysis of 82 randomized controlled trials that evaluated clinical outcomes in 125,053 patients taking two or more of the following regimens:

• Nonselective NSAIDs (NSNSAIDS) alone

• NSNSAIDs with proton pump inhibitors (PPIs)

• NSNSAIDS with H-2 receptor antagonists (H2RAs)

• NSNSAIDs with misoprostol

• Selective COX-2 inhibitors alone

• Selective COX-2 inhibitors with PPIs

• Selective COX-2 inhibitors with misoprostol

The most effective strategy to reduce complications was the combination of a selective COX-2 i…