Reliance on endoscopy makes NSAID studies unreliable

The replacement of generalised cyclo-oxygenase inhibitors with specific cyclo-oxygenase 2 inhibitors has significantly reduced the number of patients presenting with gastric ulcers caused by non-steroidal anti-inflammatory drugs. On p 291 Hawkey discusses the need for clinical outcome studies that would generate new knowledge about these drugs, especially cyclo-oxygenase 2 inhibitors. Current studies are based on endoscopic findings (instead of clinical outcomes) that may report ulcers or bleeds that are not drug induced and hence may corrupt the findings. Hawkey suggests several measures to improve outcome studies, including defining clinically important endpoints and studying the drugs in an real life setting.

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Outcomes studies of drug induced ulcer complications: do we need them and how should they be done?

C J Hawkey
BMJ 2000 321: 291-293. [Extract] [Full Text] [PDF]