NSAID-associated deaths: the rise and fall of NSAID-associated GI mortality.

Although gastrointestinal (GI) morbidity and mortality from NSAIDs continues to be a significant problem, this study by Lanas et al. indicates that the magnitude of the concern is declining. Explanations for this reduction are more likely related to the increased use of proton pump inhibitors (PPIs) than to the introduction of COX-2 inhibitors. This study further reveals that one-third of NSAIDs' GI mortality comes from low-dose, daily aspirin. Another important contribution derived from this report is a more reliable estimate of NSAIDs' lower GI clinical consequences than previously available.