Pill helps prevent aspirin-related ulcers

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Regular low-dose aspirin, taken typically to ward off a heart attack, may increase the risk of developing stomach ulcers, but this can be counteracted by taking another pill -- esomeprazole, more familiarly known as Nexium.

That finding comes from a study reported in the American Journal of Gastroenterology. Esomeprazole is a proton pump inhibitor, meaning that it suppresses gastric acid. The authors note that no studies until now have measured how often low-dose aspirin users develop stomach ulcers (as seen by endoscopy) or "to what extent ulcers are prevented by use of a proton pump inhibitor."

Dr. Neville Yeomans, at the University of Western Sydney, Australia, and colleagues studied nearly 1000 patients, 60 years of age and older, who were taking 75 to 325 milligrams of aspirin daily and were randomly assigned to also take esomeprazole or an inactive "placebo" for 26 weeks.

During the study period, endoscopic examinations revealed stomach ulcers in 5.4 percent of patients in the placebo group compared with 1.6 percent of those in the esomeprazole group, the researchers report.

Thus, esomeprazole reduces the risk of gastroduodenal ulcer in low-dose aspirin users by about 70 percent.

"The results of this study support the use of esomeprazole 20 mg once daily for reducing the risk of gastric and/or duodenal ulcers associated with the use of low-dose aspirin in patients aged 60 years and older who do not have preexisting gastroduodenal ulcers," Yeoman's team concludes.

SOURCE: American Journal of Gastroenterology, October 2008.