Research

A heartburn pill a day may keep ulcers away

For those who take certain painkiller drugs regularly to help ease arthritis pain or other chronic aches, the relief comes with a tradeoff: a quadrupled chance of developing painful ulcers over the long term, as their digestive systems brim with acid that erodes the lining of their stomachs and upper intestinal tract.

But a new study may offer a promising way to prevent this unwelcome effect. In an international, multi-center, randomized, placebo-controlled study, a prescription heartburn drug called esomeprazole effectively prevented ulcers among 573 long-term painkiller users. It also produced few side effects.

"This is a very encouraging result, especially since the participants represented the real world' population that faces this ulcer risk," says Dr. James Scheiman, a U-M Health System gastroenterologist who presented the results Oct. 14 in Baltimore at the 68th Annual Scientific Meeting of the American College of Gastroenterology (ACG). He also is a professor of internal medicine at the Medical School. "The effect was strong in participants taking over-the-counter painkillers, as well as in those taking prescription Cox-II inhibitor drugs."

Esomeprazole, which is marketed as Nexium (esomeprazole magnesium) by Astra Zeneca Pharmaceuticals LP, is a member of the class of acid-reducing drugs known as proton pump inhibitors. It blocks the production and secretion of gastric acid.

Astra Zeneca funded the study, and Scheiman is a paid member of the panel that advised the company on the study, as well as presenter of the ACG presentation.

The study results show that ulcers and other effects can be prevented by countering the acid that increases the injury to the gastrointestinal tract that can be caused by use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen, naproxen and Cox II inhibitors, all commonly used to treat chronic pain.

Scheiman says the results of the study should give hope to any patient who needs to take painkillers regularly. "With these data, and results from other studies, we can say that we have a way to prevent ulcers and other gastrointestinal effects in long-term NSAID users," he says. "There doesn't have to be a tradeoff between one kind of pain and another."

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