Monday, May 29, 2023
This program is designed for gastroenterologists and healthcare professionals who treat and manage patients with NSAID-induced gastric ulcers and acid reflux. There are no prerequisites to participate in this activity.
Protection from acid-related esophageal mucosal injury is a main treatment objective for gastroesophageal reflux disease (GERD).
Gastroprotective strategies in GERD are proving useful in the treatment of gastrointestinal (GI) mucosal complications related
to the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Nonsteroidal anti-inflammatory drugs are among the most widely used medications worldwide. [1] Approximately 50 million Americans use over-the-counter NSAIDs either occasionally or regularly. [2] While NSAIDs are highly effective in treating pain and inflammation, these agents are associated with an increased risk of
clinically significant upper GI adverse events. Although the individual risk for an NSAID-related GI complication is low,
the widespread use of these agents magnifies this frequency into a large absolute number of serious GI events.
Multiple strategies are available to manage the risks associated with NSAIDs while preserving the analgesic and anti-inflammatory benefit associated with cyclooxygenase (COX) inhibition. The 2 prevailing strategies currently used to decrease the risks of NSAID-associated GI events are: (1) cyclooxygenase-2 (COX-2)–selective agents (COX-2 inhibitors) and (2) proton-pump inhibitor (PPI) co-therapy. The COX-2 inhibitors have equivalent efficacy and reduced risk of GI adverse events in the absence of concomitant aspirin use compared with nonselective agents; however, recent data suggest that all COX-2 inhibitors are associated with some degree of an increased cardiovascular risk. These data resulted in the withdrawal of both rofecoxib (Vioxx ®) and valdecoxib (Bextra ®) from the market and the addition of a "black box" warning to the celecoxib (Celebrex ®) label. The use of a gastroprotective agent, such as a PPI, for the prevention of NSAID-related GI complications is increasingly
being considered because of its well-established safety profile, efficacy in GERD, and ability to reduce the incidence of
gastric and duodenal ulcers and associated adverse outcomes.
Upon completion of this activity, participants should be able to:
It is the policy of SCEPTER™ that all persons who are in a position to control the educational content of a sponsored activity are expected to disclose any relevant financial relationships they/spouse/partner have with the commercial supporters and/or providers/manufacturers of commercial services/products included in the content of the educational activity. It is also necessary that they disclose any discussion of non-FDA-approved (off-label), experimental, or investigational use of drugs or devices in the content of the activity. SCEPTER fully complies with the ACCME Standards for Commercial Support policy on provider's responsibility to resolve conflicts of interest of participating faculty, and has assumed this responsibility by providing independent review. Based on this review, SCEPTER is confident that any conflicts have been resolved and that the content is fair balanced and evidence based, notwithstanding the financial interest and affiliations disclosed.
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This activity is provided for educational purposes only. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.
SCEPTER is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
SCEPTER™ designates this educational activity for a maximum of 1.5 Category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability
and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page.
Follow these steps to earn CME/CE credit*:
You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it.
Credits will be tallied in your CME/CE Tracker and archived for 5 years; at any point within this time period you can print
out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.
*The credit that you receive is based on your user profile.
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Protection from acid-related esophageal mucosal injury is a main treatment objective for gastroesophageal reflux disease (GERD). Gastroprotective strategies in GERD are proving useful in the treatment of gastrointestinal (GI) mucosal complications related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Nonsteroidal anti-inflammatory drugs are among the most widely used medications worldwide.[1] Approximately 50 million Americans use over-the-counter NSAIDs either occasionally or regularly.[2] While NSAIDs are highly effective in treating pain and inflammation, these agents are associated with an increased risk of clinically significant upper GI adverse events. Although the individual risk for an NSAID-related GI complication is low, the widespread use of these agents magnifies this frequency into a large absolute number of serious GI events.
Multiple strategies are available to manage the risks associated with NSAIDs while preserving the analgesic and anti-inflammatory benefit associated with cyclooxygenase (COX) inhibition. The 2 prevailing strategies currently used to decrease the risks of NSAID-associated GI events are (1) cyclooxygenase-2 (COX-2)–selective agents (COX-2 inhibitors) and (2) proton-pump inhibitor (PPI) co-therapy. The COX-2 inhibitors have equivalent efficacy and reduced risk of GI adverse events in the absence of concomitant aspirin use compared with nonselective agents; however, recent data suggest that all COX-2 inhibitors are associated with some degree of an increased cardiovascular risk. These data resulted in the withdrawal of both rofecoxib (Vioxx®) and valdecoxib (Bextra®) from the market and the addition of a "black box" warning to the celecoxib (Celebrex®) label. The use of a gastroprotective agent, such as a PPI, for the prevention of NSAID-related GI complications is increasingly being considered because of its well-established safety profile, efficacy in GERD, and ability to reduce the incidence of gastric and duodenal ulcers and associated adverse outcomes.
