リウマチ財団調査後の聖マリアンナ医科大学における非ステロイド抗炎症薬による胃十二指腸粘膜障害発生頻度調査

抄録

Conventional NSAIDs therapy include the risk of developing significant injury to upper gastrointestinal (GI) tract and annualized incidence rate of symptomatic ulcer and ulcer complication in NSAIDs users ranged from 2% to 4%. In a Japanese survey of 1, 068 patients with GI mucosal damages in 1989, high figures were obtained for gastric lesion, i. e., over 60% for gastric mucosal damage, about 40% for gastritis, and about 15% for gastric ulcers duo to use of NSAIDs, while the figure was under 2% for duodenal ulcers, unlike in other countries. To determine whether the frequency of NSAIDs GI lesion in recent 10 years has a lower incidence of GI lesion compared with before and we evaluated the prophylactics efficacy of teprenone against NSAIDs induced lesions.
Material and methods ; We investigated in a large scale survey of prevalence of upper GI ulcers in total patients with rheumatoid arthritis (RA) (5, 915 cases) and osteoarthritis (OA) (3, 377 cases) who were required NSAIDs therapy and also evaluated NSAIDs ulcer prevention by co-administration of teprenone. Evaluated period was ranged from 1991 to 1999.
Results and conclusions ; The GI ulcer complications were seen more than 2 from 1991 to 1993. However, incidence of lesions was gradually deceasing from 1994 and at 1998 and 1999, occurrence rate of GI ulcers was less than 0.5%. A comparison of incidence of GI ulcers between teprenone co-administered group (T group) and none defensive drug users group (none T group) revealed that the incidence was significantly lower for the T group than none T group.
These results indicated that the incidence NSAIDs induced GI ulcers in Japan was obviously decreasing and teprenone extras a strong prophylactic effect against NSAIDs induced lesions.