Am J Epidemiol 2004; 159:23-31.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Risk of Uncomplicated Peptic Ulcer among Users of Aspirin and Nonaspirin Nonsteroidal Antiinflammatory Drugs
1 Centro Español de Investigación Farmacoepidemiológica, Madrid, Spain.
2 Slone Epidemiology Center, Boston University, Boston, MA.
The association between nonsteroidal antiinflammatory drugs (NSAIDs) and upper gastrointestinal complications is well documented. However, epidemiologic data on the risk of clinically symptomatic but uncomplicated peptic ulcer are quite limited. The authors studied the association between prescription NSAIDs and the risk of symptomatic ulcer in a population-based cohort of 458,840 persons and 1,167,469 person-years in the United Kingdom between 1995 and 1999 and conducted a nested case-control analysis of 1,197 cases and 10,000 controls. The relative risk and 95% confidence intervals were estimated and adjusted for several factors known to be associated with gastrointestinal damage. The incidence rate of symptomatic ulcer was 1.03 (95% confidence interval (CI): 0.97, 1.08) cases per 1,000 person-years. Compared with nonusers, the relative risk was 2.9 (95% CI: 2.3, 3.6) for aspirin and 4.0 (95% CI: 3.2, 5.1) for nonaspirin NSAID users. For aspirin users, the relative risk was similar for doses up to 300 mg daily and for both gastric and duodenal ulcers. For nonaspirin NSAIDs, the relative risk was 2.6 (95% CI: 2.0, 3.5) for medium daily doses or lower and 4.9 (95% CI: 3.8, 6.5) for high daily doses; it was 5.6 (95% CI: 3.9, 8.2) for gastric and 3.1 (95% CI: 2.3, 4.2) for duodenal ulcers. The risk of symptomatic ulcer for aspirin and nonaspirin NSAIDs was elevated throughout treatment. These findings suggest that NSAIDs might not only complicate but also originate clinically relevant peptic ulcers.
anti-inflammatory agents, non-steroidal; aspirin; drug toxicity; peptic ulcer
Abbreviations: Abbreviations: CI, confidence interval; GPRD, General Practice Research Database; ICD, International Classification of Diseases, Eighth Revision; NSAID, nonsteroidal antiinflammatory drug; RR, relative risk.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D H Solomon, N J Goodson, J N Katz, M E Weinblatt, J Avorn, S Setoguchi, C Canning, and S Schneeweiss Patterns of cardiovascular risk in rheumatoid arthritis Ann Rheum Dis, December 1, 2006; 65(12): 1608 - 1612. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Munsterhjelm, T. T. Niemi, O. Ylikorkala, P. J. Neuvonen, and P. H. Rosenberg Influence on platelet aggregation of i.v. parecoxib and acetaminophen in healthy volunteers Br. J. Anaesth., August 1, 2006; 97(2): 226 - 231. [Abstract] [Full Text] [PDF]
|
|