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Biotech / Medical : Biotech Valuation -- Ignore unavailable to you. Want to Upgrade?

To: FiloF who wrote (13431)	10/11/2004 10:10:16 AM
From: Biomaven	Respond to of 52153

Prilosec can help prevent stomach ulcers caused by NSAIDs Just to elaborate a bit: The cox-2 inhibitors are certainly no better than the standard NSAIDs in terms of their efficacy - in fact most people think they are a little worse. Their sole advantage lies in their being "stomach friendly" - traditional NSAIDs cause bleeding ulcers in a significant number of people that take them regularly. (And note that putting some sort of coating on them doesn't help - it's their systemic action that's the problem as they block the stomach's defense mechanism against acid). So one obvious idea is to simply combine the two drugs and take them together. This is apparently efective in preventing ulcers. (See abstract below). Not sure why nobody has gotten around to making a combination pill yet - seems a pretty obvious idea and you'd get Waxman-Hatch exclusivity. Gastroenterol Clin Biol. 2004 Apr;28 Spec No 3:C77-83. Related Articles,Links [Curative and preventive treatment of NSAID-associated gastroduodenal ulcers] [Article in French] Dupas JL, Grigy C. Service d'Hepato-Gastroenterologie, CHU Hopital Nord, 80054 Amiens Cedex. dupas.jean-louis@chu-amiens.fr The use of treatments to heal or to prevent nonsteroidal anti-inflammatory drugs (NSAIDs) associated gastroduodenal lesions is based on replacement of mucosal prostaglandin deficiency or inhibition of acid secretion. Four-week acid suppression by proton pump inhibitors (PPI) with 7-day eradication triple therapy in Helicobacter pylori positive patients is effective in healing gastric and duodenal ulcer upon discontinuation of NSAIDs. In the event NSAIDs must be continued, PPIs (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg) are more effective than H2-blockers and cytoprotective agents (sucralfate, misoprostol) to heal mucosal lesions. In long-term prevention studies, omeprazole 20 mg, lansoprazole 15 mg, and pantoprazole 20 mg significantly reduce gastric and duodenal ulcer rates. Misoprostol 800 microg is as effective as PPIs for preventing symptomatic and complicated gastric ulcers, but less effective to prevent duodenal ulcer, with a high rate of adverse effects such as diarrhea. Helicobacter pylori eradication in infected patients decrease the risk of NSAIDs-associated lesions but is less effective than concomitant antisecretory treatment. Current data from comparative studies of PPIs vs ranitidine or misoprostol are in favor of the PPIs as well tolerated and effective drugs in the prophylaxis of NSAIDs-related gastroduodenal lesions in high-risk patients.