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Hospitalization for gastrointestinal adverse events attributable to the use of low-dose aspirin among patients 50 years or older also using non-steroidal anti-inflammatory drugs: a retrospective cohort study.
Aliment Pharmacol Ther. 2007 Nov 15; 26(10):1387-98.AP

Abstract

BACKGROUND

Use of aspirin with non-steroidal anti-inflammatory drugs increases the risk of gastrointestinal ulcers; however, it is not clear if this risk varies with the non-steroidal anti-inflammatory drug used.

AIM

To assess the risk of gastrointestinal hospitalizations attributable to aspirin in patients 50 years or older also using non-steroidal anti-inflammatory drugs.

METHODS

Administrative data of patients 50 years or older who received a non-steroidal anti-inflammatory drug or acetaminophen prescription between 1998 and 2004 were used.

RESULTS

Study patients received 7,412,992 non-steroidal anti-inflammatory drug prescriptions and 5,614,044 acetaminophen prescriptions among which 23% and 32%, respectively, were dispensed to aspirin users. Time-dependent Cox regression models revealed that, compared to patients using acetaminophen (without aspirin), the adjusted hazard ratio (95% CI) among non-users of aspirin were: rofecoxib 1.3 (1.2, 1.5), celecoxib 0.7 (0.6, 0.8), diclofenac 1.5 (1.2, 1.7), ibuprofen 0.9 (0.6, 1.4), naproxen 2.5 (2.1, 3.0) and piroxicam 1.5 (0.8, 2.8); among users of aspirin: rofecoxib 3.2 (2.8, 3.7), celecoxib 1.8 (1.5, 2.1), diclofenac 2.8 (2.2, 3.5), ibuprofen 1.4 (0.8, 2.7), naproxen 2.2 (1.6, 3.0) and piroxicam 2.0 (0.8, 5.4). The risk attributable to aspirin varied from none with naproxen to 61% (53%, 68%) with celecoxib.

CONCLUSION

The increase in gastrointestinal hospitalization attributable to aspirin differed with the non-steroidal anti-inflammatory drug used, and seemed higher with cyclo-oxygenase-2 inhibitors than with non-selective non-steroidal anti-inflammatory drugs.

Authors+Show Affiliations

Department of Medicine, McGill University, Montreal, Canada. elham.rahme@mcgill.caNo 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

17892525

Citation

Rahme, E, et al. "Hospitalization for Gastrointestinal Adverse Events Attributable to the Use of Low-dose Aspirin Among Patients 50 Years or Older Also Using Non-steroidal Anti-inflammatory Drugs: a Retrospective Cohort Study." Alimentary Pharmacology & Therapeutics, vol. 26, no. 10, 2007, pp. 1387-98.
Rahme E, Nedjar H, Bizzi A, et al. Hospitalization for gastrointestinal adverse events attributable to the use of low-dose aspirin among patients 50 years or older also using non-steroidal anti-inflammatory drugs: a retrospective cohort study. Aliment Pharmacol Ther. 2007;26(10):1387-98.
Rahme, E., Nedjar, H., Bizzi, A., & Morin, S. (2007). Hospitalization for gastrointestinal adverse events attributable to the use of low-dose aspirin among patients 50 years or older also using non-steroidal anti-inflammatory drugs: a retrospective cohort study. Alimentary Pharmacology & Therapeutics, 26(10), 1387-98.
Rahme E, et al. Hospitalization for Gastrointestinal Adverse Events Attributable to the Use of Low-dose Aspirin Among Patients 50 Years or Older Also Using Non-steroidal Anti-inflammatory Drugs: a Retrospective Cohort Study. Aliment Pharmacol Ther. 2007 Nov 15;26(10):1387-98. PubMed PMID: 17892525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospitalization for gastrointestinal adverse events attributable to the use of low-dose aspirin among patients 50 years or older also using non-steroidal anti-inflammatory drugs: a retrospective cohort study. AU - Rahme,E, AU - Nedjar,H, AU - Bizzi,A, AU - Morin,S, Y1 - 2007/09/24/ PY - 2007/9/26/pubmed PY - 2008/4/1/medline PY - 2007/9/26/entrez SP - 1387 EP - 98 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 26 IS - 10 N2 - BACKGROUND: Use of aspirin with non-steroidal anti-inflammatory drugs increases the risk of gastrointestinal ulcers; however, it is not clear if this risk varies with the non-steroidal anti-inflammatory drug used. AIM: To assess the risk of gastrointestinal hospitalizations attributable to aspirin in patients 50 years or older also using non-steroidal anti-inflammatory drugs. METHODS: Administrative data of patients 50 years or older who received a non-steroidal anti-inflammatory drug or acetaminophen prescription between 1998 and 2004 were used. RESULTS: Study patients received 7,412,992 non-steroidal anti-inflammatory drug prescriptions and 5,614,044 acetaminophen prescriptions among which 23% and 32%, respectively, were dispensed to aspirin users. Time-dependent Cox regression models revealed that, compared to patients using acetaminophen (without aspirin), the adjusted hazard ratio (95% CI) among non-users of aspirin were: rofecoxib 1.3 (1.2, 1.5), celecoxib 0.7 (0.6, 0.8), diclofenac 1.5 (1.2, 1.7), ibuprofen 0.9 (0.6, 1.4), naproxen 2.5 (2.1, 3.0) and piroxicam 1.5 (0.8, 2.8); among users of aspirin: rofecoxib 3.2 (2.8, 3.7), celecoxib 1.8 (1.5, 2.1), diclofenac 2.8 (2.2, 3.5), ibuprofen 1.4 (0.8, 2.7), naproxen 2.2 (1.6, 3.0) and piroxicam 2.0 (0.8, 5.4). The risk attributable to aspirin varied from none with naproxen to 61% (53%, 68%) with celecoxib. CONCLUSION: The increase in gastrointestinal hospitalization attributable to aspirin differed with the non-steroidal anti-inflammatory drug used, and seemed higher with cyclo-oxygenase-2 inhibitors than with non-selective non-steroidal anti-inflammatory drugs. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/17892525/Hospitalization_for_gastrointestinal_adverse_events_attributable_to_the_use_of_low_dose_aspirin_among_patients_50_years_or_older_also_using_non_steroidal_anti_inflammatory_drugs:_a_retrospective_cohort_study_ L2 - https://doi.org/10.1111/j.1365-2036.2007.03523.x DB - PRIME DP - Unbound Medicine ER -