In this study, researchers from the United States assessed the risk of ulcers with low-dose aspirin, as well as the interaction of low-dose aspirin with a COX-2 selective inhibitor.
The team performed a double-blind trial comparing placebo, low-dose aspirin, rofecoxib plus low-dose aspirin, and ibuprofen.
The team studied osteoarthritis patients, aged 50 years, without ulcers or erosive esophagitis at baseline endoscopy.
Patients were randomly assigned to receive either placebo, enteric-coated aspirin 81 mg/day, rofecoxib 25 mg combined with aspirin 81 mg/day, or ibuprofen 800 mg 3 times a day.
The doctors performed repeat endoscopies at 6 and 12 weeks.
|Addition of a COX-2 selective inhibitor to low-dose aspirin increased ulcer incidence.|
The team calculated that the 12-week cumulative incidence of ulcers was 6% for placebo, 7% for aspirin, 16% for rofecoxib, and 17% for ibuprofen.
They also found that the mean increases in the number of erosions were 0.17 for placebo, 0.85 for aspirin, 1.67 for rofecoxib combined with aspirin, and 1.91 for ibuprofen.
Dr Loren Laine's team concluded, "Low-dose aspirin alone did not significantly increase ulcer incidence".
"Addition of a COX-2 selective inhibitor to low-dose aspirin increased ulcer incidence, to a rate not significantly less than a nonselective nonsteroidal anti-inflammatory drug (NSAID) alone".
"Determining the relative impact of COX-2 selective inhibitors and nonselective NSAIDs on gastrointestinal mucosal injury in low-dose aspirin users will require further study".