In this manufacturer-funded trial, 404 patients starting ASA (dose range 75mg-325mg) underwent baseline and 12-week endoscopy, and were randomized to placebo or famotidine 20mg BID. At 12 weeks, the famotidine group had significantly fewer gastric ulcers (3% vs 15%), duodenal ulcers (1% vs 9%), and erosive esophagitis (4% vs 19%) compared to placebo. Famotidine is an effective strategy to prevent ASA-associated ulcers/esophagitis (abstract).
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July 24, 2009 |
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About the Author: Danielle Scheurer
Danielle Scheurer, MD, MSCR, SFHM is a clinical hospitalist and the Chief Quality Officer at the Medical University of South Carolina in Charleston, South Carolina, where she also serves as Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She is also the President of SHM's Board of Directors and previously served as Physician Editor of The Hospitalist, SHM's monthly newsmagazine.
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Considering that patients were endoscopically screened at the end of the study, looking for the presence of esophageal, gastric and duodenal mucosa alterations, there is a considerable possibility that the investigators diagnosed clinically non-significant complications. This study looks very well designed but it shouldn’t be used yet to guide clinical decisions. Clinicians should wait for a study powered to detect clinically significant complications.
Daniel Capurro, MD.