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MR Vol.12 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.1 |
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Effectiveness of omeprazole for the treatment
of upper gastrointestinal lesions in rheumatoid arthritis patients |
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| S. Ito3, S. Nozawa1, H. Ishikawa2, C. Tohyama2,
K. Nakazono2, A. Murasawa2, M. Nakano3, M. Arakawa3, F. Gejyo3 |
(1)Department of Medicine, Rheumatic Center
of Niigata Prefectual Senami Hospital, Murakami, Japan
(2)Department of Orthopedic Surgery, Rheumatic Center of Niigata Prefectural
Senami Hospital, Murakami, Japan
(3)Department of Medicine (II), Niigata University School of Medicine, 1-757
Asahimachi-dori, Niigata 951-8510, Japan |
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| Abstract |
| Abstract We evaluated the efficacy of omeprazole
(OPZ) for the treatment of upper gastrointestinal (UGI) lesions in
rheumatoid arthritis (RA) patients. Fourteen RA patients with H2
receptor antagonist- (H2RA-) resistant UGI lesions (1 stomal, 11
gastric, and 2 esophageal with reflux esophagitis ulcers) were treated
with OPZ at 20 mg/day (study A). New untreated UGI lesions (1 stomal
and 12 gastric ulcers) were treated with OPZ (study B). Three patients
who showed renal dysfunction during H2RA treatment for UGI lesion
were treated with OPZ (study C). Nonsteroidal antiinflammatory drugs
(NSAIDs) were not discontinued. The stage of each ulcer was determined
by gastrointestinal fiberscopy (GIF). In study A, during the first
8 weeks of OPZ treatment, 1 esophageal and 7 gastric ulcer patients
were completely cured. Six patients showing partial response were
treated further with OPZ for another 8 weeks. During this second
period, 1 stomal and 3 gastric ulcer patients were completely cured,
and 1 gastric and 1 esophageal ulcer patient showed only partial
response. In study B, after an 8-week OPZ treatment, all except 2
patients showed complete healing. One patient developed mild eruption
at 4 weeks and was shifted to H2RA. One patient showed complete healing
after 4 weeks. No patient in study C showed renal dysfunction with
OPZ. Our results suggest that OPZ is an effective treatment for UGI
lesions in RA patients using NSAIDs. |
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| Key words |
| Key words H2 receptor antagonist-resistant ulcer
・ Omeprazole (OPZ) ・ Rheumatoid arthritis (RA) |
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