Non-steroidal anti-inflammatory drugs use and risk of upper gastrointestinal adverse events in cirrhotic patients
| Autor: | Mei-Shu Lai, Min-Shung Lin, Yen-Chieh Lee, Hsi-Chieh Chen, Jou-Wei Lin, Chia-Hsuin Chang |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Liver Cirrhosis Male Peptic Ulcer medicine.medical_specialty Databases Factual Gastrointestinal Diseases Histamine Antagonists Comorbidity Esophageal and Gastric Varices Risk Assessment Gastroenterology Young Adult Duodenitis Internal medicine medicine Humans Adverse effect Outpatient pharmacy Aged Aged 80 and over Sulfonamides Cyclooxygenase 2 Inhibitors Hepatology business.industry Anti-Inflammatory Agents Non-Steroidal Proton Pump Inhibitors Odds ratio Middle Aged medicine.disease Logistic Models Celecoxib Gastritis Concomitant Pyrazoles Female Diagnosis code medicine.symptom business medicine.drug |
| Zdroj: | Liver International. 32:859-866 |
| ISSN: | 1478-3223 |
| DOI: | 10.1111/j.1478-3231.2011.02739.x |
| Popis: | Background/Aims The upper gastrointestinal (GI) toxicity associated with non-steroidal anti-inflammatory drugs (NSAID) use among cirrhotic patients remains unclear. The objective of this study was to evaluate the risk of upper GI adverse events associated with celecoxib and oral and parenteral non-selective NSAIDs in cirrhotic patients. Methods All the patients aged ≥ 20 years with a diagnosis of cirrhosis hospitalized for variceal bleeding and non-variceal upper GI adverse events (oesophageal, gastric, duodenal ulcer, bleeding; gastritis and duodenitis) in 2006 were identified using ICD-9-CM diagnosis codes from inpatient claims from the Taiwan National Health Insurance Database. In the case-crossover study design, the case period was defined as 1–30 days and the control period as 31–60 days before the date of hospitalization. The information for individual NSAID use was obtained from the outpatient pharmacy prescription database. Adjusted self-matched odds ratios (OR) and their 95% confidence intervals (CI) were estimated with a conditional logistic regression model. Results A total of 4876 cirrhotic patients were included. The adjusted OR (95% CI) was 1.44 (0.89–2.31) for celecoxib, 1.87 (1.66–2.11) for oral non-selective NSAIDs and 1.90 (1.55–2.32) for parenteral NSAIDs overall. Risks were similar for variceal and non-variceal events. Concomitant use of proton pump inhibitors and histamine-2 receptor antagonists tended to decrease the upper GI toxicity associated with non-selective NSAIDs and celecoxib. Conclusion The use of nsNSAIDs but not celecoxib was associated with a two-fold increased risk of variceal and non-variceal upper GI events among cirrhotic patients. |
| Databáze: | OpenAIRE |
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