Clinical Opinion: Addressing unmet needs for patients with previous upper gastrointestinal bleed requiring concomitant aspirin and non-steroidal anti-inflammatory drugs

摘要

The CONCERN trial was an industry-independent, doubleblind,double-dummy randomised controlled trial performedin a single centre in Hong Kong between 24 May 2005 and9 November 2015. There was a lack of data to address thechoice of non-steroidal anti-infl ammatory drugs (NSAIDs) inpatients who were on low-dose aspirin and had a backgroundof gastrointestinal (GI) bleed. The working hypothesis wasthat for prevention of recurrent GI bleed in these patients,cyclo-oxygenase(COX)-2 selective NSAIDs, in combinationwith proton-pump inhibitors (PPIs) were superior to non-COXselective NSAIDs plus PPIs. Participants had had an upperGI bleed but needed NSAIDs for chronic arthritis not relievedby simple analgesics; and at the same time needed aspirinfor cardiac event prophylaxis.