Key result
Switching to clopidogrel matches continued aspirin for ulcer healing at 8 weeks.
Why the study?
The gastrotoxicity of clopidogrel in patients with active aspirin-induced peptic ulcer disease was unknown.
Does clopidogrel plus omeprazole improve ulcer healing compared to aspirin plus omeprazole in patients with aspirin-induced peptic ulcer disease?
Comparison
Clopidogrel (75 mg/day) plus omeprazole (20 mg/day) vs low-dose aspirin plus omeprazole (20 mg/day)
Design
Single-blind randomized controlled study
Authors
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Supports continuing aspirin plus PPI without mandatory switch; confirms equivalent healing to clopidogrel in this RCT.
RCT (n=129)
Single-blind
randomized
Does clopidogrel plus omeprazole improve ulcer healing compared to aspirin plus omeprazole in patients with aspirin-induced peptic ulcer disease?
Absolute Event Rate: 94% vs 95%
In patients with aspirin-associated peptic ulcer disease of low to moderate grade, both early conversion to clopidogrel and continuation of aspirin (both with omeprazole) result in similarly high rates of ulcer healing.
Ng et al. (2004) conducted an RCT in aspirin-induced peptic ulcer disease (n=129). Clopidogrel vs. low-dose aspirin was evaluated on ulcer/erosion healing at the eighth week. In patients with aspirin-induced peptic ulcer disease, early conversion to clopidogrel resulted in a 94% ulcer healing rate at 8 weeks, compared to 95% with continued low-dose aspirin.
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