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Omeprazole vs famotidine to prevent gastroduodenal injury in aspirin users

Omeprazole vs famotidine to prevent gastroduodenal injury in aspirin users Omeprazole vs famotidine to prevent gastroduodenal injury in aspirin users
Omeprazole vs famotidine to prevent gastroduodenal injury in aspirin users Omeprazole vs famotidine to prevent gastroduodenal injury in aspirin users

A  randomized controlled trial was carried to explore whether omeprazole (proton pump inhibitor) has superior efficacy compared to famotidine (histamine-2 receptor antagonists) to prevent mucosal breaks in 170 high-risk users of low-dose aspirin having a peptic ulcer history and who did not have mucosal breaks at initial endoscopy. 

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Key take away

Omeprazole is superior to famotidine in preventing gastroduodenal mucosal breaks in elevated-risk users of aspirin. Smoking is an independent and vital risk factor for the development of gastroduodenal mucosal breaks.

Background

randomized controlled trial was carried to explore whether omeprazole (proton pump inhibitor) has superior efficacy compared to famotidine (histamine-2 receptor antagonists) to prevent mucosal breaks in 170 high-risk users of low-dose aspirin having a peptic ulcer history and who did not have mucosal breaks at initial endoscopy. 

Method

Participants were randomly allocated to receive omeprazole (20 mg once a day, n=86) or famotidine (20 mg twice daily, n=84) for six months. The follow-up endoscopy was carried at the end of the sixth month and whenever hematemesis, epigastric discomfort, or melena occurred. The gastroduodenal mucosal break occurrence was the major endpoint. Secondary outcomes were the occurrence of gastroduodenal ulcers and gastroduodenal bleeding.

Result

The incidence of gastroduodenal mucosal breaks was higher in famotidine-recipients compared to omeprazole recipients. The two groups had similar incidence rates of gastroduodenal ulcers, and gastroduodenal bleeding, as depicted below:


The multivariate analysis demonstrated that proton pump inhibitor use was an independent protective factor (odds ratio: 0.47). Smoking was found to be a pivotal risk factor for the occurrence of gastroduodenal mucosal breaks (odds ratio: 3.84).

Conclusion

Proton pump inhibitors have superior efficacy compared to histamine-2 receptor antagonists in preventing gastroduodenal mucosal breaks in high-risk aspirin users. For the occurrence of mucosal breaks, smoking is an independent risk factor.

Source:

Journal of the Chinese Medical Association

Article:

Omeprazole vs famotidine for the prevention of gastroduodenal injury in high-risk users of low-dose aspirin: A randomized controlled trial

Authors:

Zhi-Fu Tseng et al.

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