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COX-2-selective inhibitors and the risk of upper gastrointestinal bleeding in high-risk patients with previous gastrointestinal diseases: a population-based case-control study.
Aliment Pharmacol Ther. 2004 Apr 01; 19(7):817-25.AP

Abstract

BACKGROUND

Clinical trials have suggested that cyclo-oxygenase-2-selective inhibitors are associated with a lower risk of upper gastrointestinal bleeding than are non-selective, non-aspirin, non-steroidal anti-inflammatory drugs. This has not yet been confirmed in studies of patients with an increased susceptibility to upper gastrointestinal bleeding.

AIM

To examine the risk of upper gastrointestinal bleeding in high-risk patients who filled prescriptions for cyclo-oxygenase-2 inhibitors or other non-steroidal anti-inflammatory drugs.

METHODS

A population-based case-control study was performed in the Danish county of North Jutland from 1 January 2000 to 31 December 2002. From the County Hospital Discharge Registry and the Civil Registration System, we identified incident cases with upper gastrointestinal bleeding (n = 780) and randomly selected controls (n = 2906), respectively. All cases and controls had previous gastrointestinal diseases. Data on drug exposure were obtained from the countywide Prescription Database.

RESULTS

Thirty-five cases (4.5%) filled prescriptions for cyclo-oxygenase-2 inhibitors within 30 days of the date of upper gastrointestinal bleeding, compared with 79 controls (2.7%). Adjusted odds ratios for upper gastrointestinal bleeding according to prescription for celecoxib, rofecoxib and non-steroidal anti-inflammatory drugs were 1.3 [95% confidence interval (CI), 0.7-2.8], 2.1 (95% CI, 1.2-3.5) and 3.3 (95% CI, 2.4-4.4), respectively.

CONCLUSIONS

In patients with increased susceptibility to gastrointestinal adverse events, a lower risk of upper gastrointestinal bleeding was observed in users of cyclo-oxygenase-2 inhibitors compared with users of other non-aspirin, non-steroidal anti-inflammatory drugs.

Authors+Show Affiliations

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. bn@soci.au.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15043523

Citation

Nørgård, B, et al. "COX-2-selective Inhibitors and the Risk of Upper Gastrointestinal Bleeding in High-risk Patients With Previous Gastrointestinal Diseases: a Population-based Case-control Study." Alimentary Pharmacology & Therapeutics, vol. 19, no. 7, 2004, pp. 817-25.
Nørgård B, Pedersen L, Johnsen SP, et al. COX-2-selective inhibitors and the risk of upper gastrointestinal bleeding in high-risk patients with previous gastrointestinal diseases: a population-based case-control study. Aliment Pharmacol Ther. 2004;19(7):817-25.
Nørgård, B., Pedersen, L., Johnsen, S. P., Tarone, R. E., McLaughlin, J. K., Friis, S., & Sørensen, H. T. (2004). COX-2-selective inhibitors and the risk of upper gastrointestinal bleeding in high-risk patients with previous gastrointestinal diseases: a population-based case-control study. Alimentary Pharmacology & Therapeutics, 19(7), 817-25.
Nørgård B, et al. COX-2-selective Inhibitors and the Risk of Upper Gastrointestinal Bleeding in High-risk Patients With Previous Gastrointestinal Diseases: a Population-based Case-control Study. Aliment Pharmacol Ther. 2004 Apr 1;19(7):817-25. PubMed PMID: 15043523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COX-2-selective inhibitors and the risk of upper gastrointestinal bleeding in high-risk patients with previous gastrointestinal diseases: a population-based case-control study. AU - Nørgård,B, AU - Pedersen,L, AU - Johnsen,S P, AU - Tarone,R E, AU - McLaughlin,J K, AU - Friis,S, AU - Sørensen,H T, PY - 2004/3/27/pubmed PY - 2004/7/21/medline PY - 2004/3/27/entrez SP - 817 EP - 25 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 19 IS - 7 N2 - BACKGROUND: Clinical trials have suggested that cyclo-oxygenase-2-selective inhibitors are associated with a lower risk of upper gastrointestinal bleeding than are non-selective, non-aspirin, non-steroidal anti-inflammatory drugs. This has not yet been confirmed in studies of patients with an increased susceptibility to upper gastrointestinal bleeding. AIM: To examine the risk of upper gastrointestinal bleeding in high-risk patients who filled prescriptions for cyclo-oxygenase-2 inhibitors or other non-steroidal anti-inflammatory drugs. METHODS: A population-based case-control study was performed in the Danish county of North Jutland from 1 January 2000 to 31 December 2002. From the County Hospital Discharge Registry and the Civil Registration System, we identified incident cases with upper gastrointestinal bleeding (n = 780) and randomly selected controls (n = 2906), respectively. All cases and controls had previous gastrointestinal diseases. Data on drug exposure were obtained from the countywide Prescription Database. RESULTS: Thirty-five cases (4.5%) filled prescriptions for cyclo-oxygenase-2 inhibitors within 30 days of the date of upper gastrointestinal bleeding, compared with 79 controls (2.7%). Adjusted odds ratios for upper gastrointestinal bleeding according to prescription for celecoxib, rofecoxib and non-steroidal anti-inflammatory drugs were 1.3 [95% confidence interval (CI), 0.7-2.8], 2.1 (95% CI, 1.2-3.5) and 3.3 (95% CI, 2.4-4.4), respectively. CONCLUSIONS: In patients with increased susceptibility to gastrointestinal adverse events, a lower risk of upper gastrointestinal bleeding was observed in users of cyclo-oxygenase-2 inhibitors compared with users of other non-aspirin, non-steroidal anti-inflammatory drugs. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/15043523/COX_2_selective_inhibitors_and_the_risk_of_upper_gastrointestinal_bleeding_in_high_risk_patients_with_previous_gastrointestinal_diseases:_a_population_based_case_control_study_ L2 - https://doi.org/10.1111/j.1365-2036.2004.01913.x DB - PRIME DP - Unbound Medicine ER -