To avoid stomach upset in arthritis patients, drug combination more effective

UCLA/VA researchers found that for arthritis patients, taking a combination of two drugs may be most effective in protecting against stomach upset called dyspepsia, which is a side effect of common pain medications.

Published this week in The American Journal of Medicine, the study showed that for arthritis patients, taking an anti-inflammatory drug like Naproxen with an acid-reducing drug like Prevacid may prove more effective than taking a Cox-2 inhibitor like Celecoxib alone for protecting against stomach upset.

More than 15 million Americans suffer from chronic arthritis, including osteoarthritis and rheumatoid arthritis. According to researchers, non-steroidal anti-inflammatory drugs (NSAIDS) are the most commonly used medications for these conditions, but often cause gastrointestinal discomfort known as dyspepsia.

"Dyspepsia can be a major problem for patients, causing stomach upset symptoms such as nausea, bloating, gas and belching," said Dr. Brennan M.R. Spiegel, study author and director, UCLA/VA Center for Outcomes Research and Education (CORE). "These symptoms are far more common than more serious side effects like ulcers or bleeding."

Researchers found that compared to taking an over-the-counter anti-inflammatory by itself, a Cox-2 inhibitor taken alone reduced dyspepsia occurrence by 12 percent. An anti-inflammatory taken with an acid-reducing drug together, however, lowered incidence of dyspepsia by 66 percent.

"The drug combination was significantly more effective in reducing dyspepsia and may prove to be the preferred treatment for arthritis patients at high risk for stomach problems," said Spiegel, assistant professor of medicine, David Geffen School of Medicine at UCLA and Veterans Affairs Greater Los Angeles Healthcare System.

The study involved a systematic review of clinical trial findings in medical literature and then researchers conducted a more sensitive meta-analysis of the results.

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The study is funded by TAP Pharmaceuticals Products, Inc., manufacturer of lansoprazole, a proton pump inhibitor, which is marketed under the brand name Prevacid. Spiegel is also a consultant for TAP.

In addition to Spiegel, other researchers include Mary Farid, DO; Dr. Gareth S. Dulai; Dr. Ian M. Gralnek and Dr. Fasiha Kanwal.


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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