Prophylaxe und Therapie NSAR-induzierter Ulzera: ein Update

Nicht-steroidale Antirheumatika (NSAR) können bei bis zur Hälfte der Patienten Symptome wie Dyspepsie und Übelkeit sowie eine Anorexie verursachen ([26]). Nur 2-4 % der Patienten entwickeln symptomatische Ulzera und Ulkuskomplikationen wie Blutung, Perforation und Obstruktion. Schwere gastrointestinale Nebenwirkungen, die zu einer Hospitalisation oder sogar zum Tod des Patienten führen, treten nur in ca. 2 % der Fälle auf. Dies erscheint wenig, ist jedoch angesichts der großen Zahl an Patienten, die NSAR einnehmen, von großer Bedeutung. Im Folgenden werden die heute gesicherten Kenntnisse über die Ulkusprophylaxe mit säurehemmenden Medikamenten und Prostaglandin sowie die Behandlung von Ulzera, die unter einer Therapie mit NSAR auftreten, besprochen.

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