Aspirin and Proton Pump Inhibitor Combination Therapy for Prevention of Cardiovascular Disease and Barrett's Esophagus
العنوان: | Aspirin and Proton Pump Inhibitor Combination Therapy for Prevention of Cardiovascular Disease and Barrett's Esophagus |
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المؤلفون: | David A. Peura, C. Mel Wilcox |
المصدر: | Postgraduate Medicine. 126:87-96 |
بيانات النشر: | Informa UK Limited, 2014. |
سنة النشر: | 2014 |
مصطلحات موضوعية: | medicine.medical_specialty, Combination therapy, medicine.drug_class, Fixed-dose combination, Proton-pump inhibitor, Gastroenterology, Medication Adherence, Barrett Esophagus, Stomach Neoplasms, Internal medicine, Antithrombotic, medicine, Humans, Neoplastic transformation, Adverse effect, Aspirin, business.industry, Proton Pump Inhibitors, General Medicine, medicine.disease, Drug Combinations, Cardiovascular Diseases, Barrett's esophagus, Colorectal Neoplasms, Gastrointestinal Hemorrhage, business, Platelet Aggregation Inhibitors, medicine.drug |
الوصف: | Aspirin, used at low doses (75-325 mg daily), prevents aggregation of platelets and is prescribed for patients as pharmacologic prevention of cardiovascular disease. Despite the well-documented beneficial effects of aspirin, prolonged use is associated with damage to the gastrointestinal (GI) mucosa in the upper and lower GI tract. Patient risk of hemorrhage and peptic ulcer formation is increased with older age, previous ulcer history, Helicobacter pylori infection, and concomitant use of nonsteroidal anti-inflammatory drugs, corticosteroids, or antithrombotic agents. As termination of aspirin therapy can precipitate a cardiovascular event, patients at risk need co-therapy with gastroprotective agents, such as proton pump inhibitors (PPIs), to reduce the GI side effects of aspirin treatment. Fixed-dose combinations of low-dose aspirin and gastroprotective agents have been designed to increase medication compliance, improve clinical outcomes, and reduce the overall cost of therapy. Prolonged use of PPIs may, however, lead to serious adverse effects or, in some cases, reduce the cardioprotective effects of aspirin. Hence, physicians need to carefully consider the benefits and risks associated with the condition of each patient to optimize clinical outcomes of combination therapy. A growing body of clinical evidence indicates that aspirin may decrease the risk of colorectal and other GI cancers, as well as reduce progression from Barrett's esophagus (BE) to esophageal adenocarcinoma. Furthermore, PPIs have recently been shown to reduce neoplastic transformation in patients with BE. Thus, the use of a fixed-dose aspirin/PPI combination could potentially provide chemopreventive benefit to patients with BE, and, at the same time, treat the underlying gastroesophageal reflux responsible for the condition. |
تدمد: | 1941-9260 0032-5481 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2fd6b07ed5b2a22d56ab14eec2273576 https://doi.org/10.3810/pgm.2014.01.2728 |
رقم الأكسشن: | edsair.doi.dedup.....2fd6b07ed5b2a22d56ab14eec2273576 |
قاعدة البيانات: | OpenAIRE |
تدمد: | 19419260 00325481 |
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