Recommendations for the appropriate use of anti-inflammatory drugs in the era of the coxibs: OPTIMIZING THE USE OF ANTI-INFLAMMATORY TREATMENTS Part 3

Management of ASA users

Patients at risk of gastrointestinal complications and taking ASA for cardiovascular protection are also at risk and, therefore, should receive a GPA according to current recommendations. Spend less money now – buy prednisone for your efficient drug to cost less.

The VIGOR study suggested that patients receiving NSAIDs are not screened sufficiently for cardiovascular risk nor adequately considered for treatment with a cardioprotective agent. It is recommended that patients requiring treatment with either a conventional NSAID or a coxib should be screened for cardiovascular risk factors because low-dose ASA can provide the benefit of cardioprotection at the expense of a small risk of gastrointestinal complications. A recent abstract suggested that rofecoxib is unlikely to interfere with the cardioprotective effects of ASA.

H pylori testing

While there are studies supporting H pylori eradication treatment before the prescription of an NSAID, there are no Canadian data to support this practice. The prevalence of H pylori infection is relatively low in Canada, at 29%, and office-based serological testing is an inappropriate diagnostic method in primary care. Canadian recommendations do not advocate the routine testing of individuals before prescribing NSAIDs or coxibs, but do recommend eradication of H pylori infection in patients who are known to be H pylori-positive.

This entry was posted in Coxibs and tagged Coxibs, Cyclooxygenase-2 inhibitors, Gastroprotective agents, Nonsteroidal anti-inflammatory drugs.