A team from Hong Kong, China, investigated the role of gastric acid suppression in preventing the recurrence of ulcer complications in patients taking long-term low-dose aspirin.
A total of 123 patients, who had ulcer complications after using low-dose aspirin continuously for more than 1 month and who had Helicobacter pylori infection, were enrolled in the study.
After the ulcers had healed and the H. pylori infection was eradicated, the patients were randomly assigned to treatment with 30 mg of lansoprazole daily or placebo for 12 months. This was in addition to 100 mg of aspirin daily.
The primary end point was the recurrence of ulcer complications.
|Recurrence of ulcer complications:|
| New England Journal of Medicine |
During a median follow-up of 12 months, 15% of the 61 patients in the placebo group, as compared with 2% of the 62 patients in the lansoprazole group, had a recurrence of ulcer complications (adjusted hazard ratio, 9.6).
Of the 10 patients who had recurrence of ulcer problems, 4 had evidence of a recurrence of H. pylori infection and 2 had taken nonsteroidal anti-inflammatory drugs before the onset of complications.
The researchers found that patients in the lansoprazole group were significantly less likely to have a recurrence of ulcer complications than patients in the placebo group.
There was no significant difference in mortality between the two groups.
Kam Chuen Lai, of the Queen Mary Hospital, Hong Kong, concluded on behalf of the group, "In patients who had ulcer complications related to the long-term use of low-dose aspirin, treatment with lansoprazole, in addition to the eradication of H. pylori infection, significantly reduced the rate of recurrence of ulcer complications."