We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Nonsteroidal Anti-inflammatory Drugs and Gastrointestinal Injury in Children-Reply

Am J Dis Child. 1993;147(12):1280. doi:10.1001/archpedi.1993.02160360022007.
Text Size: A A A
Published online


In Reply.—Although there are no published pediatric studies that directly address the question of increased risk for peptic ulcer disease in children with juvenile rheumatoid arthritis (JRA) who receive both corticosteroids and an NSAID, the overall reported frequency of gastrointestinal hemorrhage or positive stools for occult blood in collaborative NSAID studies is low.

In a placebo-controlled trial of methotrexate in 127 children with JRA, a stable dosage of prednisone as well as two NSAIDs were permitted. In that study, there was a low occurrence of gastrointestinal side effects (12 patients), and no patient had gastrointestinal hemorrhage or was dropped from the study owing to gastrointestinal problems.1 In addition, current recommended management of other rheumatic diseases in children, especially systemic lupus erythematosus, often involves concomitant use of both corticosteroids and an NSAID, including aspirin.2 No studies to date suggest an increased risk for significant gastrointestinal toxic effects in


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.