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Review
. 2020 Nov 15;14(6):707-726.
doi: 10.5009/gnl20246.

Clinical Guidelines for Drug-Related Peptic Ulcer, 2020 Revised Edition

Moon Kyung Joo  1 , Chan Hyuk Park  2 , Joon Sung Kim  3 , Jae Myung Park  4 , Ji Yong Ahn  5 , Bong Eun Lee  6 , Jeong Hoon Lee  5 , Hyo-Joon Yang  7 , Yu Kyung Cho  4 , Chang Seok Bang  8 , Beom Jin Kim  9 , Hye-Kyung Jung  10 , Byung-Wook Kim  3 , Yong Chan Lee  11 ; Korean College of Helicobacter Upper Gastrointestinal Research
Affiliations
Review

Clinical Guidelines for Drug-Related Peptic Ulcer, 2020 Revised Edition

Moon Kyung Joo et al. Gut Liver. .

Abstract

Korean guidelines for nonsteroidal anti-inflammatory drug (NSAID)-induced peptic ulcer were previously developed in 2009 with the collaboration of the Korean College of Helicobacter and Upper Gastrointestinal Research and Korean Society of Gastroenterology. However, the previous guidelines were based mainly upon a review of the relevant literature and expert opinion. Therefore, the guidelines need to be revised. We organized a guideline Development Committee for drug-related peptic ulcer under the auspices of the Korean College of Helicobacter and Upper Gastrointestinal Research in 2017 and developed nine statements, including four for NSAIDs, three for aspirin and other antiplatelet agents, and two for anticoagulants through a de novo process founded on evidence-based medicine that included a literature search and a meta-analysis, A consensus was reached through the application of the modified Delphi method. The primary target of these guidelines is adult patients undergoing long-term treatment with NSAIDs, aspirin or other antiplatelet agents and anticoagulants. The revised guidelines reflect the expert consensus and is intended to assist clinicians in the management and prevention of druginduced peptic ulcer and associated conditions.

Keywords: Anticoagulants; Antiplatelet agent; Guideline; Non-steroidal anti-inflammatory agents; Peptic ulcer.

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Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Flowchart of study selection for the prevention of peptic ulcers with cyclooxygenase-2 inhibitors in NSAID users. NSAID, nonsteroidal anti-inflammatory drug; RCT, randomized controlled trial.
Fig. 2
Fig. 2
The preventive effect of selective COX-2 inhibitors on gastroduodenal ulcers in long-term NSAID users. Forest plot, COX-2 versus placebo (subgroup analysis by assessment timing). G, gastric ulcer; D, duodenal ulcer; NSAID, nonsteroidal anti-inflammatory drug; COX-2, cyclooxygenase-2; CI, confidence interval; M-H, Mantel Haenszel.
Fig. 3
Fig. 3
Therapeutic algorithm for LDA users with a history of PUB. LDA, low-dose aspirin; PUB, peptic ulcer bleeding; PPI, proton pump inhibitor.
See this image and copyright information in PMC

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