DOI: https://doi.org/10.22263/2312-4156.2026.1.49
R.A. Pavlyukov1, M.R. Konorev1, A.S. Tsuran2
Prevention of gastric and duodenal mucosal injury in patients with seropositive rheumatoid arthritis treated with long-term meloxicam using proton pump inhibitors
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2026;25(1):49-58.
Abstract.
Objectives. To evaluate the prophylactic effect of omeprazole during long-term administration of meloxicam in patients with rheumatoid arthritis, using rheumatoid factor as a reliable predictor of the risk of developing adverse reactions in the form of erosive and ulcerative lesions of the stomach and duodenum.
Material and Methods. The study included 188 patients diagnosed with rheumatoid arthritis who were prescribed meloxicam at a dose of 15 mg daily for 4-8 years. Patients were divided into groups according to serologic status (seropositive and seronegative) and the presence or absence of H. pylori infection.
Results. The study found that in patients with seropositive rheumatoid arthritis infected with H. pylori and not receiving proton pump inhibitors (PPIs), the incidence of gastroduodenal erosions and ulcers was 87.9%. In the group of patients with seropositive rheumatoid arthritis who received meloxicam together with omeprazole, this indicator was 13.2%, which indicates a significant reduction in the risk of complications. In the group of patients with seropositive rheumatoid arthritis, uninfected with H. pylori and taking meloxicam, the incidence of gastroduodenal erosions and ulcers was 73.1% in patients without PPIs and 5% in patients receiving omeprazole.
Conclusions. The administration of omeprazole in combination with meloxicam for rheumatoid arthritis can reliably reduce the number of erosive-ulcerative lesions of the gastroduodenal membrane. PPIs are effective in preventing nonsteroidal gastropathy associated with long-term NSAID use in patients with rheumatoid arthritis, using rheumatoid factor as a reliable predictor of the risk of developing adverse reactions such as erosive and ulcerative lesions of the stomach and duodenum. These drugs can be recommended for widespread clinical implementation.
Keywords: rheumatoid arthritis, rheumatoid factor, meloxicam, nonsteroidal gastropathy, erosions, ulcers, stomach, duodenum, pharmacological prophylaxis, proton pump inhibitor, omeprazole.
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Submitted 06.11.2025
Accepted 16.02.2026
Information about authors:
Roman A. Pavlyukov – senior lecturer of the Chair of General & Clinical Pharmacology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
M.R. Konorev – Doctor of Medical Sciences, professor, head of the Chair of General & Clinical Pharmacology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
A.S. Tsuran – endoscopist of the endoscopy department, Vitebsk Regional Clinical Hospital.
