Gastric erosions induced by nonsteroidal anti-inflammatory drugs: clinical significance, pathogenesis, and therapeutic perspectives

The development of ulceration and ulcer complications by nonsteroidal anti-inflammatory drugs (NSAIDs) is now well established. Gastric erosions occur in about 60% of patients receiving long-term NSAID therapy. Many clinicians consider such erosions benign in nature and not requiring therapeutic intervention. Recent evidence, however, indicates that gastric erosions predispose rheumatic patients to frank ulcerations and ulcer complications. This brief overview summarizes the clinical dilemma in the diagnosis and treatment of NSAID-induced gastric erosions. Current data suggest that misoprostol has important therapeutic benefits for the treatment and prevention of gastric erosions in patients receiving long-term NSAID therapy.