Must We Stop Prophylactic Aspirin in Patients Who Develop Peptic Ulcers?

Allan S. Brett, MD

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In these patients with aspirin-related peptic ulceration, the short-term effectiveness of proton-pump inhibitor (PPI) therapy was not compromised when aspirin was continued. The trial was neither large enough nor long enough for investigators to examine important clinical outcomes such as cardiovascular ischemic events or gastrointestinal bleeding. However, the results provide support for continuing aspirin while initiating PPI therapy in patients with strong indications for aspirin (e.g., known cardiovascular disease). But, if indications for aspirin are marginal (as is often the case when low-risk patients use aspirin for primary prevention), stopping aspirin if peptic ulcers develop is prudent.

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