Key result
Individualized risk assessment, timely antithrombotic resumption, and mandatory PPI co-therapy optimize high-risk PUD management.
Why the study?
A shift toward drug-induced peptic ulcer disease combined with increasing antithrombotic use has created a high-risk population requiring balanced bleeding and thrombotic risk management.
This review highlights the importance of individualized risk assessment, timely resumption of antithrombotics, and PPI co-therapy in managing peptic ulcer disease in patients on antithrombotic agents.
Supports individualized antithrombotic resumption and PPI co-therapy in high-risk PUD; leaves open prospective validation.
The management of peptic ulcer disease (PUD) in patients receiving antithrombotic therapy requires balancing bleeding and thrombotic risk. The shift from Helicobacter pylori-dominant to drug-induced PUD combined with increasing antithrombotic use has created a new high-risk population that demands particular attention. In this review, we synthesize the current evidence from Korean and international guidelines, focusing on practical management strategies for the acute treatment and long-term prevention of PUD. Key recommendations include individualized risk assessment of bleeding and thrombotic risks, timely resumption of antithrombotic agents following successful hemostasis, and mandatory proton pump inhibitor co-therapy for high-risk patients. Multidisciplinary collaboration and evidence-based approaches are necessary to optimize patient outcomes while minimizing gastrointestinal and cardiovascular complications.
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Bang et al. (2026) conducted a review in Peptic Ulcer Disease in patients taking antithrombotic agents. Proton pump inhibitors and H. pylori eradication was evaluated. Individualized risk assessment, timely resumption of antithrombotic agents following hemostasis, and mandatory proton pump inhibitor co-therapy are recommended for managing PUD in high-risk patients.
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