Based on current references four clinical scenarios were discussed and different management strategies were compared for secondary and primary prophylaxis of @entity1066 or peptic @entity1066 under continuous therapy with non-steroidal antiinflammatory drugs (NSAID) or low-dose- @entity117 , for @entity1534 -positive and @entity1534 -negative @entity1 . Used as secondary prophylaxis eradication alone is insufficient in preventing recurrent @entity10189 or recurrent @entity1066 for @entity1534 -positive @entity1 who continue to take unselective NSAIDs. Maintenance therapy with PPIs or switching from nonselective NSAID to COX-2-inhibitors is required after eradication of @entity1534 or primary @entity1534 -negative @entity1 . Further evaluation is needed of what kind of secondary prophylaxis - maintenance therapy with PPI or switching to COX-2-inhibitor - is more (cost-)effective. It is sufficient to use eradication of @entity1534 alone as secondary prophylaxis in preventing recurrent @entity10189 or recurrent @entity1066 for @entity1534 -positive @entity1 , who continue to take low-dose- @entity117 . Maintenance therapy with PPI is not generally required. However it can be considered for @entity1 with increased risk for @entity344 (previous history of @entity10189 , age over 65 years, concomitant use of @entity288 , anticoagulants or individual NSAID with higher risk for @entity344 , serious @entity65 ). Switching from low-dose- @entity117 to @entity1397 is not required. Used as primary prophylaxis in preventing @entity10189 or @entity1066 before starting long-term therapy with NSAIDs, COX-2-inhibitors or unselective NSAIDs concomitant with PPIs are recommended for @entity1 with increased risk for @entity344 . @entity1 starting long-term therapy with unselective NSAIDs should be screened for @entity1534 and eradicated. There are no valid data supporting screening for @entity1534 and eradication for @entity1 starting long-term therapy with low-dose- @entity117 . Further studies are needed to evaluate a possible benefit for @entity1 with increased risk for @entity344 .

[Secondary and primary prophylaxis of gastropathy associated with nonsteroidal antiinflammatory drugs or low-dose- XXXX : a review based on four clinical scenarios].

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity10189 :: ('MESH:D010437', 'Disease') :: ['peptic ulcer'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer', 'ulcer bleeding'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal complications'] @entity1534 :: ('210', 'Species') :: ['H.pylori'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disease'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids']
@entity117 :: (MESH:D001241,Chemical) :: ['aspirin']
