Vnitr Lek 2002, 48(11):1075-1081

[Gastropathies caused by non-steroidal antirheumatic agents].

P Dítě, I Novotný: Interní gastroenterologická klinika Lékarská fakulty MU a FN Brno.

Non-steroid antirheumatics are among very frequently prescribed drugs. They can be, however, associated with the development of serious and undesirable effects on the digestive tract. Therefore at present therapeutic procedures are sought which will restrict the negative effect of drugs on the mucous membranes of the stomach, duodenum and gut in general, incl. new forms of non-steroid antirheumatics with a "sparing" effect on the gastroduodenal mucous membranes. This group of drugs includes preparations with a so-called preferential or specific effect on cyclooxygenase 2 (COX-2). This enzyme is of fundamental importance for the development of mucosal lesions and its inhibition is the basis of safe medication with non-steroid antirheumatics. Other possible alternative therapy is the combined administration of non-steroid antirheumatics with drugs which inhibit the secretion of gastric hydrochloric acid. These drugs include above all proton pump blocking agents. The principle of medication with non-steroid antirheumatics should, of course, be careful and correct indication, knowing possible complications of treatment, and in particular knowledge which groups of subjects may be threatened by treatment with non-steroid antirheumatics. Preference of drugs on the basis of COX-2 inhibition is a necessity in these subjects.