Nonsteroidal anti-inflammatory drugs (NSAIDs) have become one of the most commonly used medications in Western nations since the introduction of the first NSAID, aspirin, about 1 century ago. It is estimated that more than 70 million NSAID prescriptions and more than 30 billion of over-the-counter aspirin, ibuprofen, ketoprofen, and naproxen preparations are sold annually in the United States.<sup>38Lichtenstein D.R., Syngal S., Wolfe M.M. Nonsteroidal antiinflammatory drugs and the gastrointestinal tract Arthritis Rheum 1995 ;  38 : 5-18 [cross-ref]

Cliquez ici pour aller à la section Références, 44McCarthy D.M. Nonsteroidal antiinflammatory drug-induced ulcers: Management by traditional therapies Gastroenterology 1989 ;  96 : 662-674

Cliquez ici pour aller à la section Références</sup> NSAIDs are generally well tolerated; however, their use frequently is limited by adverse gastrointestinal effects ranging from dyspepsia to serious complications, such as bleeding or perforation from gastric or duodenal ulcers.

Although adverse effects of NSAIDs occur only in a few individuals, the widespread use of NSAIDs has resulted in a substantial number of affected persons who experience serious gastrointestinal complications. It is estimated that 10% to 20% of NSAID users report dyspeptic symptoms, and 5% to 15% of rheumatoid arthritis patients taking NSAIDs are expected to discontinue medications because of dyspepsia.<sup>36Larkai E.N., Smith J.L., Lidsky M.D., et al. Gastroduodenal mucosa and dyspeptic syndrome in arthritic patients during chronic non-steroid anti-inflammatory drug use Am J Gastroenterol 1987 ;  82 : 1153-1158

Cliquez ici pour aller à la section Références, 59Singh G., Ramey D.R., Morfeld D., et al. Gastrointestinal tract complications of nonsteroidal antiinflammatory drug treatment in rheumatoid arthritis: A prospective observational cohort study Arch Intern Med 1996 ;  156 : 1530-1536

Cliquez ici pour aller à la section Références</sup> A prospective study from the Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) has showed that the rate of NSAID-related gastrointestinal complications requiring hospitalization was 6 times higher in patients with rheumatoid arthritis who were taking NSAIDs than in those who were not.<sup>61Singh G., Triadafilopoulus G. Epidemiology of NSAID-induced GI complications J Rheumatol 1999 ;  26 (suppl) : 18-24

Cliquez ici pour aller à la section Références</sup> Despite a decline in the rate of hospitalization from NSAID-related gastrointestinal disorders, the mortality of hospitalized patients remains about 5% to 10%.<sup>2Armstrong C.P., Blower A.L. Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration Gut 1987 ;  28 : 527-532 [cross-ref]

Cliquez ici pour aller à la section Références, 60Singh G., Ramey D.R., Terry R., et al. NSAID-related effects on the GI tract: An ever widening spectrum Arthritis Rheum 1997 ;  40 (suppl) : S93

Cliquez ici pour aller à la section Références</sup> In 1997, the estimated death rate from NSAID-related complications in patients with arthritis was equivalent to that from acquired immunodeficiency syndrome (AIDS).<sup>58Singh G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy Am J Med 1998 ;  105 : 31S-38S

Cliquez ici pour aller à la section Références, 61Singh G., Triadafilopoulus G. Epidemiology of NSAID-induced GI complications J Rheumatol 1999 ;  26 (suppl) : 18-24

Cliquez ici pour aller à la section Références</sup> The medical costs related to NSAID-associated gastrointestinal complications have been reported to exceed $2 billion annually.<sup>69Wolfe M.M., Lichtenstein D.R., Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs N Engl J Med 1999 ;  340 : 1888-1899 [cross-ref]

Cliquez ici pour aller à la section Références</sup>