Introduction Nonsteroidal anti-inflammatory drugs (NSAIDs), one of the most commonly used medications worldwide, are frequently associated with gastrointestinal adverse events

Introduction Nonsteroidal anti-inflammatory drugs (NSAIDs), one of the most commonly used medications worldwide, are frequently associated with gastrointestinal adverse events. were cautiously developed taking into account existing literature, current practices, and expert opinion of the panelists. Results The expert panel developed a total of fifteen practice recommendations. Following are the important recommendations: NSAIDs should be prescribed only when necessary; before prescribing NSAIDs, associated modifiable and non-modifiable risk factors should be considered; infection should be considered and treated before initiating NSAIDs; patients should be properly educated regarding NSAIDs use; patients who need to be on long-term NSAIDs should be prescribed a gastroprotective agent, preferably a proton pump inhibitor and these patients should be closely monitored for any untoward adverse events. Conclusion/clinical significance These practice recommendations will serve as an important tool for main care physicians and will guide them in making appropriate therapeutic choices for their patients. How to cite this short article: Hunt R, Lazebnik LB, Marakhouski YC, Manuc M, Ramesh GN, Aye KS, Bordin DS, Bakulina NV, Iskakov BS, Khamraev AA, Stepanov YM, Ally R, Garg A. International Consensus on Guiding Recommendations for Management of Patients with Nonsteroidal Anti-inflammatory Drugs Induced Gastropathy-ICON-G. Euroasian J Hepatogastroenterol, 2018;8(2):148-160. contamination, smoking, chronic alcohol abuse, and concomitant use of other medications increase the risk of developing NIG.3,10-13 The NSAIDs have remained the first-line for controlling pain and inflammation particularly in patients with osteoarthritis (OA). Total withdrawal from NSAIDs is not usually practical, particularly in patients with chronic musculoskeletal disorders. Therefore, it is important that clinicians prescribe NSAIDs wiselyto make sure maximum benefits and minimize AEs. All healthcare practitioners, particularly main care physicians (PCP) can reduce the risk of NIG by careful patient assessment and identification of the risk factors before prescribing an NSAID, educating patients against the addition of OTC NSAIDs, using selective cyclooxygenase-2 (COX-2) inhibitors as first-line medications where appropriate,and co-therapy with a gastroprotective agent (GPA).1,3,9 Several international and regional guidelines have been developed to manage NSAID-induced GI complications.10-17 However, none specifically CPA inhibitor focus on management of NIG highlighting the need for a comprehensive clinical guidelineto guideline PCPs in the management of NIG, particularly in resource-limited regions of the world. This short article presents practice recommendations primarily targeted towards main care providers, for prevention, early detection, and management of NIG formulated at a meeting held in Dubai, UAE on CPA inhibitor December 1st, 2016. OBJECTIVE The objective of this consensus meeting was to identify the improvements in disease management and the opportu-nitiesfor prevention and management of NIG in nine nations. Further, we attempted to develop definitive clinical practice guidelines for the management of patients with NIG based on the existing literature, real-world evidence, and evidence-based practice. Ameeting was held before the International Congress of GI Experts, Gastrosphere 2.0 (in Dubai, UAE) in association with the healthy belly initiative (HSI). The committee of experts Mouse monoclonal to Epha10 from nine nations was named the ICON-G group. Expert associates proposed recommendations for use by PCPs and internists in the prevention, identification, and management of NIG. METHODS A altered Delphi consensus process (Fig. 1) was applied to develop the recommendations.18,19 Literature was searched to provide evidence, and recommendations were developed by combining evidence-based and expert consensus-based approach. A comprehensive methodology and transparency in reporting were adopted to develop these clinical practice recommendations. Open in a separate windows Fig. 1: Modified Delphi protocol for consensus development The CPA inhibitor process was conducted in two phases. Phase one included an online survey and literature search. The online survey(on online portal survey monkey. com) included twenty questions to establish the current clinical practice in the nine countries. The responses collected from your survey were then used to quantify theknowledgeand practice space in each of the countries. An electronic literature search was conducted in PubMed and MEDLINE. The search strategy was developed by combining Medical Subject Headings.