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The shift from Helicobacter &lt;i&gt;pylori&lt;\/i&gt;-dominant to drug-induced PUD combined with increasing antithrombotic use has created a new high-risk population that demands particular attention. In this review, we synthesize the current evidence from Korean and international guidelines, focusing on practical management strategies for the acute treatment and long-term prevention of PUD. Key recommendations include individualized risk assessment of bleeding and thrombotic risks, timely resumption of antithrombotic agents following successful hemostasis, and mandatory proton pump inhibitor co-therapy for high-risk patients. Multidisciplinary collaboration and evidence-based approaches are necessary to optimize patient outcomes while minimizing gastrointestinal and cardiovascular complications.<\/jats:p>","DOI":"10.7704\/kjhugr.2026.0002","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:49:28Z","timestamp":1780966168000},"page":"116-124","update-policy":"https:\/\/doi.org\/10.7704\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Peptic Ulcer Disease in Patients Taking Antithrombotic Agents"],"prefix":"10.7704","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4908-5431","authenticated-orcid":true,"given":"Chang Seok","family":"Bang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3996-3472","authenticated-orcid":true,"given":"Eun Jeong","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4435","reference":[{"key":"ref1","volume-title":""},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-015-0452-2"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(24)00155-7"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(09)60938-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(02)07273-2"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2005.10.006"},{"key":"ref7","first-page":"2167","volume-title":"Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990-2023","year":"2025"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.09.035"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-019-0225-y"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/s0049-3848(03)00379-7"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12219"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0670"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(13)62343-0"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.5009\/gnl20079"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12588"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2020.0407"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.122.026723"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.7704\/kjhugr.2014.14.1.6"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.480"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.04.016"},{"key":"ref21","first-page":"228","volume-title":"Is gastroduodenal biopsy safe in patients receiving aspirin and clopidogrel?: a prospective, randomized study involving 630 biopsies","author":"Whitson","year":"2011"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.curtheres.2017.03.006"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-325184"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315131"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.5009\/gnl240176"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.7704\/kjhugr.2023.0040"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.7704\/kjhugr.2023.0034"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15865"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(18)30037-2"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.7704\/kjhugr.2021.0063"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7270.1183"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.11.007"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.973008"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(04)16721-4"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-321585"},{"key":"ref36","first-page":"2051","volume-title":"ACCF\/ACG\/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF\/ACG\/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. 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