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Low-dose aspirin: protection from the panacea11 Lai KC, Lam SK, et al. Lansoprazole for the Prevention of Recurrences of Ulcer Complications From Long-Term Low-Dose Aspirin Use N Engl J Med 2002;346:2033–8

The American Journal of Gastroenterology
Nature Publishing Group
Publication Date
DOI: 10.1016/s0002-9270(02)05551-x
  • World Literature Review


Abstract Lai et al. prospectively studied the role of gastric acid suppression in the prevention of recurrence of ulcer complications after eradication of Helicobacter pylori ( H. pylori) infection in patients taking long-term low-dose aspirin. They enrolled 123 H. pylori-treated patients who had developed ulcer complications 1 month or longer after commencing low-dose aspirin treatment. The primary endpoints were clinical (recurrence of ulcer complications defined as bleeding, perforation, or obstruction). A total of 245 (243 with gastric outlet obstruction and two with upper GI bleeding) patients were screened. Of these, 171 were infected with H. pylori and 123 met the criteria for inclusion into the study. These patients were randomized to 100 mg of aspirin and 30 mg of lansoprazole (62 patients) or to 100 mg of aspirin and a matched placebo (61 patients). The mean duration of follow-up was 12 months. Fourteen upper GI events were reported to a blinded committee that confirmed 10 adverse outcomes. There was one (1.6%) episode of GI bleeding in the lansoprazole group compared with nine (14.8%) in the placebo group (adjusted hazards ratio = 9.6, 95% CI = 1.2–76.1). However, four of the nine patients in the placebo group had a recurrence of H. pylori, and two had taken nonsteroidal anti-inflammatory drugs. The authors concluded that in patients with ulcer complications related to the long-term use of low-dose aspirin, treatment with lansoprazole in addition to the eradication of H. pylori infection significantly reduce the rate of recurrence of ulcer complications.

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