GI healthcare resource use in 6009 patients switching from chronic NSAID to COX-2 specific inhibitor therapy and the effect of prior PPI use

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“…We strongly considered inclusion of misoprostol in our clinical scenarios, and the sponsor had no input on our exclusion of this agent. Rather, our prior studies 6, 7 had revealed that misoprostol is rarely used in the USA (misoprostol and sucralfate usage combined represents only 3–6% of all GI co‐therapy with NSAIDs). This may well be due to the need for more frequent dosing and the significant increase in diarrhoea and days with abdominal pain with misoprostol, documented in Dr Graham's study 3 .…”