ABSTRACT
During the last 15 years management of patients who need to take non-steroidal anti-inflammatory drugs [NSAIDs] has been revolutionized by the availability or co-prescription of prostaglandin analogues such as misoprostol or proton pump inhibitors and by the emergence of selective inhibitors of the inducible cyclo-oxygenase [COX]-2 enzyme. This paper describes work mainly from the Division of Gastroenterology [now Wolfson Digestive Diseases Centre], that investigated numerous strategies in acute and/or explanatory studies before evaluating their effectiveness in large patient studies with endoscopy or clinical outcome as an endpoint The data show, contrary to common pre-conception, that acute changes are highly predictive of patient outcomes. It seems likely that some strategies that were never evaluated in patient studies would he effective
ABSTRACT
During the last 15 years management of patients who need to take non-steroidal anti-inflammatory drugs [NSAIDs] has been revolutionised by the availability,for co-prescription of prostaglandin analogues such as misoprostol or proton pump inhibitors and by the emergence of selective inhibitors of the inducible cyclo-oxygenase [COX]-2 enzyme. This paper describes work mainly from the Division of Gastroenterology [now Wolfson Digestive Diseases Centre], that investigated numerous strategies in acute and/or explanatory studies before evaluating their effectiveness in large patient studies with endoscopy or clinical outcome as an endpoint. The data show, contrary to common pre-conception, that acute changes are highly predictive of patient outcomes. It seems likely that some strategies that were never evaluated in patient studies would be effective