Profilassi del danno da FANS

While the most effective strategy to prevent non-steroidal anti-inflammatory drugs (NSAIDs) related gastrointestinal lesions, is to not prescribe them, this option is often impractical. The use of specific agents to prevent NSAIDs toxicity has focused upon two approaches: replacement of prostaglandin deficiency and inhibition of acid secretion. H2 blockers significantly reduce duodenal ulcer rates, but are ineffective in preventing gastric ulceration. In long term prevention studies, proton pump inhibitors have been shown to reduce the risk of gastric and duodenal ulcers and NSAID-related dyspepsia. Recent comparative studies of PPIs versus H2 antagonists and misoprostol showed that, after 6-12 months of follow up, the proton pump inhibitors were significantly superior to control drugs in reducing the risk both of gastric and duodenal ulcer.