In a nutshell
This study examined the frequency of gastrointestinal (digestive tract) events in at-risk rheumatic patients using non-steroidal anti-inflammatory drugs.
Some background
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) are used to relieve pain in patients with rheumatic diseases. However, they can also cause gastrointestinal events such as stomach bleeding and stomach ulcers.
The frequency of gastrointestinal (GI) events associated with NSAID use may be higher in patients that have certain risk factors, such as a previous peptic ulcer (a painful sore in the lining of the stomach). GI events associated with NSAID use may also be higher in elderly patients and patients that have an increased risk of a cardiovascular event (heart attack or stroke). Taking other drugs such as oral corticosteroids (such as prednisone), anticoagulants (such as Coumadin) or anti-depression drugs (such as Zoloft) can also increase the risk.
Lack of patient adherence to guidelines can occur as a result of GI events. However, this can reduce the effectiveness of the drug.
Methods & findings
This study aimed to determine the frequency of GI events in at-risk rheumatic patients using NSAIDs. This study involved 4144 participants that had at least one risk factor for a GI event. 27% of patients had a history of uncomplicated GI events (such as heartburn or ulcer). 3% had a history of complicated GI events (such as a bleeding ulcer).
All participants had recently begun NSAID treatment. The number of patients experiencing upper (esophagus and stomach) and lower (intestines) GI events over 6 months was recorded. Cardiovascular events (such as stroke or heart attack) were also recorded.
12% of participants experienced upper GI events. 1% of participants experienced lower GI events. Cardiovascular events were reported in 0.5% of patients. 28% of patients reported using medications to lower stomach acid production on a regular basis.
The bottom line
This study concluded that GI events are more common in the upper GI tract in comparison to the lower GI tract in at-risk rheumatic patients.
The fine print
Extending the study period would enable the frequency of GI events to be assessed over the long-term.
What’s next?
Consult your physician regarding the risks and benefits of NSAID use if you are at a higher risk of having a GI event.
Published By :
Annals of the rheumatic diseases
Date :
Apr 01, 2015
