[Gastroduodenal safety of selective inhibitors of cyclooxigenase-2: practical validation].

AIM: To evaluate rate of erosions and ulcers of the upper gastroduodenal tract (UGDT) in patients treated with selective cyclooxigenase inhibitors (C-NAID).

MATERIAL AND

METHODS

A retrospective analysis of esophagogastroduodenoscopies made in the Institute of Rheumatology in 2002-2004 was made for two groups. The study group received C-NAID (nimesulid, n = 330; meloxicam, n = 371; celecoxib, n = 66), the control group--diclofenak (n = 1935). The groups were matched by age, gender and concomitant therapy. Incidence of ulcers in the past was significantly higher in the study group.

RESULTS

Occurrence of erosions and ulcers in the study and control groups was comparable: 22.4, 24.5, 21.2 and 27.6%, respectively. Multiple erosions (ME, n > 10) and ulcers significantly less frequently occurred in the study group: 8.8, 10.5, 10.6 and 14.6%, respectively (p < 0.05). Significant difference in occurrence of erosions and ulcers in UGDT for different C-NAID was not found. ME and ulcers in patients with ulcer anamnesis were recorded less frequently in intake of C-NAID than diclofenak (22.5 and 46.2%, resopectively, p < 0.001).

CONCLUSION

Selective inhibitors of COG-2 are not safe enough in relation to gastrointestinal pathology, especially in patients with ulcer anamnesis. Nimesulid, meloxicam and celecoxibe were comparable in respect to detectability of gastrointestinal erosions and ulcers.