Study: Adding Nexium to Arthritis Pain Killers May Reduce Ulcers

People who take painkillers for their arthritis may be able to reduce their chances of developing ulcers by adding a heartburn drug to their medication regimen, according to a study reported October 14 at the annual meeting of the American College of Gastroenteroloy in Baltimore.

Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen as well as Cox II inhibitors can quadruple the chance of painful ulcers by producing acid that erodes the lining of the stomach and upper intestinal tract.

University of Michigan Health System researchers found that the heartburn drug esomeprazole (Nexium®) effectively prevented ulcers among 573 long-term painkiller users, while producing few side effects.

Nexium, a proton pump inhibitor, works against ulcers by blocking the production and secretion of gastric acid.

The participants were taking NSAIDs at least five days a week, either as one drug alone or in combination. About 15 percent were taking Cox II inhibitors (Celebrex) or rofecoxib (Vioxx). Some were also taking aspirin at doses designed to protect their cardiovascular systems.

About 12 percent of the study participants taking NSAIDs who received a placebo instead of Nexium developed ulcers, while the ulcer rate for those who received Nexium was only about 5 percent. In patients taking Cox II inhibitors for their pain, 17 percent who received placebo pills developed ulcers, compared to none who received Nexium. Only 6 percent of patients receiving it stopped taking the drug during the study because of any adverse event, compared with 13 percent of placebo patients.

"This is a very encouraging result, especially since the participants represented the real world population that faces this ulcer risk," said Dr. James Scheiman, a University of Michigan Health System gastroenterologist. "The effect was strong in participants taking over-the-counter painkillers as well as in those taking prescription Cox-II inhibitor drugs."

Instead of waiting for further studies to confirm the findings, Scheiman said clinicians should evaluate whether a Cox II inhibitor and proton pump inhibitor combination might be the best option for their patients.

Scheiman said the results should give hope to any patient who needs to take painkillers regularly. "With these data, and results from other studies, we can say that we have a way to prevent ulcers and other gastrointestinal effects, in long-term NSAID users," he says. "There doesn't have to be a tradeoff between one kind of pain and another."

Other sources: University of Michigan Health System