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Thursday 27th October 2016

43% of osteoarthritis patients not offered gastro-protection with an NSAID, despite potential serious gastrointestinal side effects

18th January 2011

New surveys* from AstraZeneca show GPs reporting that 43% of osteoarthritis (OA) patients are not offered gastro-protection with their treatment of a non-steroidal anti-inflammatory drug (NSAID), with 18% of patients reporting being offered gastro-protection only after complaining of heartburn or dyspepsia.  Guidelines from the National Institute for Health and Clinical Excellence (NICE) and National Prescribing Centre on OA recommend that GPs should co-prescribe gastro-protection in the form of a proton pump inhibitor (PPI) with an NSAID,. Interestingly, AstraZeneca’s new GP survey shows that 65% of GPs believe NICE is the main influencer of their OA management.

Despite being the most common form of arthritis, affecting some 8.5 million people in the UK compared to rheumatoid arthritis, which affects around 400,000 people, OA has been considered an “unimportant degenerative dead-end” disease. Yet there is awareness now of the extent of the public health problem OA poses, currently costing the NHS up to £70 million a year and, as the ageing population continues to grow, predicted to be the fourth leading cause of disability by 2020.  It has therefore never been more urgent to address the unmet need that OA presents.  Furthermore, the new patient survey shows that 50% of OA patients asked believe their pain is worsening2 - nearly half of patients are in pain every day, and over a fifth of them waited more than two years before even consulting their GP.

VIMOVO™ is now available from AstraZeneca and offers GPs a new choice in the management of symptomatic OA pain. A modified release tablet containing 500mg enteric-coated naproxen and 20mg film-coated esomeprazole, taken twice daily, VIMOVO™ is indicated for the symptomatic treatment of osteoarthritis (OA) in patients who are at risk of developing non-steroidal anti-inflammatory drug (NSAID)-associated gastric and/or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient. All NSAIDs carry the risk of side effects, which can be serious and life-threatening, including gastrointestinal complications such as perforation, ulcers and bleeding. For this reason, VIMOVO™ was developed as a combination of the analgesic and anti-inflammatory NSAID, naproxen, with the gastro-protectant proton pump inhibitor, esomeprazole.

Dr Chris Barker, Primary Care Specialist in Pain Medicine, commented: “For a GP, the challenge in OA is helping patients achieve pain control and functional improvement, while also managing the risk of side effects. VIMOVO™ is a welcome new option combining Naproxen with the gastro-protection of Esomeprazole in a single tablet.”

In a clinical trial programme that compared the incidence of gastric ulcers with VIMOVO™ bid (EC naproxen 500mg and IR esomeprazole 20mg) or EC naproxen 500mg bid alone in at-risk patients requiring chronic NSAID medication, the incidence of gastric ulcers was 5.6% for VIMOVO™ compared with 23.7% for EC naproxen9.

The surveys also show that:

  • Over a quarter - 26% - of OA patients interviewed are not satisfied with their treatment. 
  • A third of GPs believe achieving adequate pain control is the most challenging aspect of OA management.

Professor Richard Langford, President of the British Pain Society, has stated: “NSAIDs are a mainstay of OA treatment but their long-term use can be limited by concerns around their tolerability and patients may be at risk of gastrointestinal complications.”

OA is a leading cause of disability in the UK, with pain being the main reason that patients consult their GPs. Patients report that their pain causes distress and that OA limits their daily activities. The effects of OA reported by patients, other than pain, include stiffness, fatigue, disability, depression, anxiety and sleep disorders.

*AstraZeneca commissioned two surveys, one with OA patients and one with GPs.


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