Randomised clinical trial: rabeprazole plus aspirin is not inferior to rabeprazole plus clopidogrel for the healing of aspirin-related peptic ulcer.
Aliment Pharmacol Ther. 2011 Jul 5;
Authors: Luo JC, Huang KW, Leu HB, Chen L…

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Review article: the diagnosis and investigation of obscure gastrointestinal bleeding.
Aliment Pharmacol Ther. 2011 Jun 21;
Authors: Liu K, Kaffes AJ
Background? Obscure gastrointestinal bleeding (OGIB) is a commonly …

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Multicentre comparison of the Glasgow Blatchford and Rockall scores in the prediction of clinical end-points after upper gastrointestinal haemorrhage.
Aliment Pharmacol Ther. 2011 Jun 26;
Authors: Stanley AJ, Dalton HR, Blatch…

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Meta-analysis: antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding – an updated Cochrane review.
Aliment Pharmacol Ther. 2011 Jun 27;
Authors: Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avil…

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Review article: faecal transplantation therapy for gastrointestinal disease.
Aliment Pharmacol Ther. 2011 Jun 20;
Authors: Landy J, Al-Hassi HO, McLaughlin SD, Walker AW, Ciclitira PJ, Nicholls RJ, Clark SK, Hart AL
Ba…

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Review article: cyclic vomiting syndrome in adults – rediscovering and redefining an old entity.
Aliment Pharmacol Ther. 2011 Jun 12;
Authors: Hejazi RA, McCallum RW
Background? Cyclic vomiting syndrome is a disorder…

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Abnormal liver tests in people aged 75 and above: prevalence and association with mortality.
Aliment Pharmacol Ther. 2011 Jun 1;
Authors: Fleming KM, West J, Aithal GP, Fletcher AE
Background? Despite their common us…

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Optimising the care of patients with cirrhosis and gastrointestinal haemorrhage: a quality improvement study.
Aliment Pharmacol Ther. 2011 May 17;
Authors: Johnson EA, Spier BJ, Leff JA, Lucey MR, Said A
Background? …

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The systemic inflammatory response syndrome and sequential organ failure assessment scores are effective triage markers following paracetamol (acetaminophen) overdose.
Aliment Pharmacol Ther. 2011 May 10;
Authors: Craig DG, Re…

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Review article: drug-induced liver injury – its pathophysiology and evolving diagnostic tools.
Aliment Pharmacol Ther. 2011 May 3;
Authors: Au JS, Navarro VJ, Rossi S
Background? Drug-induced liver injury (DILI) is a…

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Systematic review: management options for primary sclerosing cholangitis and its variant forms – IgG4-associated cholangitis and overlap with autoimmune hepatitis.
Aliment Pharmacol Ther. 2011 Apr 18;
Authors: Culver EL, Chapm…

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Review article: the treatment of functional abdominal bloating and distension.
Aliment Pharmacol Ther. 2011 May;33(10):1071-1086
Authors: Schmulson M, Chang L
Aliment Pharmacol Ther 2011; 33: 1071-1086 SUMMARY: Backgro…

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Clinical predictors of poor outcomes among patients with nonvariceal upper gastrointestinal bleeding in Europe.
Aliment Pharmacol Ther. 2011 Apr 11;
Authors: Lanas A, Aabakken L, Fonseca J, Mungan ZA, Papatheodoridis GV, Piess…

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Systematic review: the presenting international normalised ratio (INR) as a predictor of outcome in patients with upper nonvariceal gastrointestinal bleeding.

Aliment Pharmacol Ther. 2011 Mar 8;

Authors: Shingina A, Barkun AN, Razzaghi A, Martel M, Bardou M, Gralnek I,

Background? The prognostic value of an elevated international normalised ratio (INR) as part of initial risk stratification in nonvariceal upper gastrointestinal bleeding (NVUGIB) remains poorly characterised. Aim? To assess the usefulness of the initial INR in patients with NVUGIB. Method  After a systematic review, we included the presenting INR and other validated prognosticators in multivariable models predicting rebleeding and mortality. Data are reported as odd ratios and 95% confidence intervals. Results? Only two of 532 candidate studies were useful, but reported disparate, highly selected NVUGIB patients with varying threshold initial INR values, yielding conflicting results on predictive ability. The RUGBE cohort included 1869 patients (mean age 66.3?±?16.8, 38.1% female) with a mean presenting INR of 1.5?±?1.7. 462 (24.7%) patients had an elevated INR (INR?>?2.5 in 7.6%). INR did not add to the prediction of rebleeding. An INR >1.5, in contradistinction, significantly predicted mortality (OR: 1.96; 95% CI: 1.13-3.41). Conclusions? An elevated INR at initial presentation does not predict rebleeding in NVUGIB. A value 1.5 or greater, however, is associated with increased patient mortality after adjustment for validated prognosticators. The INR appears most useful as proxy of co-morbid burden at the time of initial assessment in NVUGIB.

PMID: 21385193 [PubMed - as supplied by publisher]

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Review article: proton pump inhibitors with clopidogrel – evidence for and against a clinically-important interaction.

Aliment Pharmacol Ther. 2011 Feb 8;

Authors: Disney BR, Watson RD, Blann AD, Lip GY, Anderson MR

Background? The treatment of acute coronary syndromes involves a combination of antiplatelet therapies. Proton pump inhibitors are frequently recommended for patients receiving clopidogrel in addition to aspirin, to minimise the risk of bleeding. Several studies have shown that proton pump inhibitors can affect the platelet inhibitory effects of clopidogrel. However, the data on whether this has an effect on clinical outcomes are conflicting and a definitive answer is still awaited. Aim? To provide an overview of the evidence for the pharmacological interaction between proton pump inhibitors and clopidogrel and to discuss whether this interaction translates into adverse clinical outcomes. Despite recent developments, clear consensus is lacking. Methods? A search of the published literature combined with the authors’ knowledge of the field. Results? There is evidence to show that proton pump inhibitors can influence the pharmacodynamics of clopidogrel, but the data suggesting clinical effects are weak and conflicting. Supporting a clinically important interaction are four retrospective studies including over 11?000 patients prescribed both clopidogrel and a proton pump inhibitor. Evidence against a clinically important interaction is derived from over 18?000 patients from seven studies, including the only prospective trial to examine the potential interaction. Confounding variables are relevant and prospective clinical evidence is lacking. Conclusions? Proton pump inhibitors offer clear protection and the concern over clinically relevant interactions with clopidogrel is biologically plausible, but not yet proven.

PMID: 21303400 [PubMed - as supplied by publisher]

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