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**7** 

*Italy* 

**Chronic NSAIDs Therapy and** 

**Upper Gastrointestinal Tract – Mechanism of Injury, Mucosal** 

Francesco Azzaroli\*, Andrea Lisotti,

*Department of Clinical Medicine, St. Orsola-Malpighi Hospital, University of Bologna, Bologna* 

**Defense, Risk Factors for Complication Development and Clinical Management** 

Claudio Calvanese, Laura Turco and Giuseppe Mazzella

Non steroidal anti-inflammatory drugs (NSAIDs) are the most prescribed medications worldwide because of their analgesic and anti-inflammatory properties. In fact, NSAIDs are generally prescribed for pain management in musculoskeletal or osteoarticolar pathologies

About twenty million US patients were prescribed NSAIDs every year. Although NSAIDs are generally well tolerated, chronic therapy is responsible for a significant morbidity and mortality rate; in fact, the incidence of GI events is significantly higher (about four fold) in patients receiving NSAIDs chronic therapy (Shaheen et al., 2006; Lawrence et al., 1998).

NSAIDs and aspirin present a favorable benefit profile in relief from pain, inflammation reduction and contribute to lower the risk of cancer, as demonstrated by some epidemiologic and clinical studies showing a reduced incidence of colon cancer in patients receiving low-dose aspirin (Din et al., 2010; Rothwell et al., 2010; Elwood et al.,

Moreover, low-dose aspirin therapy induce a significant reduction in cardiovascular (CV) and cerebrovascular events and effectively lower the rate of deaths in patients with cardiovascular risk factors and previous CV events. On the other hand, adverse gastrointestinal events related to NSAIDs therapy occur in a little but significant amount of patients, resulting in an important morbidity and mortality; world mortality secondary to NSAIDs therapy has been estimated to be similar to that caused by HIV-related complications (Abraham et al., 2005; Laine et al., 2010). For example, in the US more than

and for rheumatic diseases, very common diseases in the general population.

**1. Introduction** 

2009).

 \*

Corresponding Author
