Esophageal mucosal injury with low-dose aspirin and its prevention by rabeprazole

Journal of Clinical Pharmacology
Mitsushige SugimotoTakahisa Furuta

Abstract

Aspirin is used widely as an antithrombotic drug for the prevention of cardiovascular and cerebrovascular events. Although aspirin increases the risk for gastrointestinal mucosal injury, the effect on esophageal mucosa is unclear. This study investigates whether aspirin induces esophageal mucosal injury and whether a proton-pump inhibitor can prevent such injury in relation to CYP2C19 genotypes. Fifteen healthy Japanese volunteers are dosed for 7 days in a 5-way randomly crossover trial: placebo, aspirin 100 mg, rabeprazole 10 mg, and aspirin 100 mg plus rabeprazole 10 mg either once daily or 4 times per day. All subjects undergo endoscopy and 24-hour intragastric pH monitoring on day 7. With the aspirin regimen, esophageal mucosal disorders occur in 7 patients (46.7%) (5, grade M; 2, grade A). The median 24-hour pH differs significantly among subjects who develop grade M or A gastroesophageal reflux disease and those who do not develop gastroesophageal reflux disease; the median pH in grade A gastroesophageal reflux disease is significantly lower (1.5 [range, 1.1-1.9]) than that in patients without gastroesophageal reflux disease (5.6 [range, 0.8-8.4], P = .04). Rabeprazole significantly inhibits acid secretion irrespective of...Continue Reading

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Citations

Jun 1, 2012·Clinical and Experimental Gastroenterology·Mitsushige Sugimoto, Takahisa Furuta
Nov 3, 2011·World Journal of Gastroenterology : WJG·Gui-Fen MaShi-Yao Chen
Apr 9, 2014·Digestive Diseases and Sciences·Mitsushige SugimotoTakahisa Furuta
May 1, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Takahiro UotaniTakahisa Furuta
Mar 13, 2014·Journal of Clinical Pharmacology·Takahiro UotaniTakahisa Furuta
May 28, 2014·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Daisuke YamaguchiRyuichi Iwakiri
Aug 2, 2012·Diagnostic and Therapeutic Endoscopy·Mitsushige SugimotoTakahisa Furuta
Nov 30, 2011·Digestion·Mitsushige SugimotoTakahisa Furuta
Dec 26, 2012·Expert Review of Gastroenterology & Hepatology·Carlos Martín-de-Argila, Pedro Martínez-Jiménez

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