Gastrointestinal adverse effects of short-term aspirin use: A meta-analysis of published randomized controlled trials

被引:28
作者
Baron J.A. [1 ]
Senn S. [2 ]
Voelker M. [3 ]
Lanas A. [4 ]
Laurora I. [7 ]
Thielemann W. [5 ]
Brückner A. [5 ]
McCarthy D. [6 ]
机构
[1] University of North Carolina School of Medicine, Chapel Hill, NC
[2] Competence Center for Methodology and Statistics, CRP Santé Strassen, Luxembourg
[3] Building K56, Bayer HealthCare
[4] University of Zaragoza CIBERehd, IIS Aragón, Zaragoza
[5] Bayer HealthCare, Wuppertal
[6] Veterans Administration Medical Center, University of New Mexico School of Medicine, Albuquerque, NM
[7] Bayer HealthCare, Morristown, NJ
关键词
Aspirin; Electronic Supplementary Material; Ibuprofen; Paracetamol; Naproxen;
D O I
10.1007/s40268-013-0011-y
中图分类号
学科分类号
摘要
Background and Objectives: Aspirin is widely used for short-term treatment of pain, fever or colds, but there are only limited data regarding the safety of this use. To summarize the available data on this topic, we conducted a meta-analysis of the published clinical trial literature regarding the gastrointestinal adverse effects of short-term use of aspirin in comparison with placebo and other medications commonly used for the same purpose. Data Sources and Methods: An extensive literature search identified 119,310 articles regarding possible adverse effects of aspirin, among which 23,131 appeared to possibly include relevant data. An automated text-mining procedure was used to score the references for potential relevance for the meta-analysis. The 3,983 highest-scoring articles were reviewed individually to identify those with data that could be included in this analysis. Ultimately, 78 relevant articles were identified that contained gastrointestinal adverse event data from clinical trials of aspirin versus placebo or an active comparator. Odds ratios (ORs) computed using a Mantel-Haenszel estimator were used to summarize the comparative effects on dyspepsia, nausea/vomiting, and abdominal pain, considered separately and also aggregated as 'minor gastrointestinal events'. Gastrointestinal bleeds, ulcers, and perforations were also investigated. Results: Data were obtained regarding 19,829 subjects (34 % treated with aspirin, 17 % placebo, and 49 % an active comparator). About half of the aspirin subjects took a single dose. Aspirin was associated with a higher risk of minor gastrointestinal events than placebo or active comparators: the summary ORs were 1.46 (95 % confidence interval [CI] 1.15-1.86) and 1.81 (95 % CI 1.61-2.04), respectively. Ulcers, perforation, and serious bleeding were not seen after use of aspirin or any of the other interventions. Conclusions: During short-term use, aspirin is associated with a higher frequency of gastrointestinal complaints than other medications commonly used for treatment of pain, colds, and fever. Serious adverse events were not observed with aspirin or any of the comparators. © 2013 The Author(s).
引用
收藏
页码:9 / 16
页数:7
相关论文
共 18 条
  • [1] Curhan G.C., Bullock A.J., Hankinson S.E., Willett W.C., Speizer F.E., Et al., Frequency of use of acetaminophen, nonsteroidal anti-inflammatory drugs, and aspirin in US women, Pharmacoepidemiol Drug Saf, 11, pp. 687-693, (2002)
  • [2] Kaufman D.W., Kelly J.P., Rosenberg L., Anderson T.E., Mitchell A.A., Recent patterns of medication use in the ambulatory adult population of the United States: The Slone survey, JAMA, 287, pp. 337-344, (2002)
  • [3] Masso Gonzalez E.L., Patrignani P., Tacconelli S., Garcia Rodriguez L.A., Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding, Arthritis Rheum, 62, pp. 1592-1601, (2010)
  • [4] Ofman J.J., MacLean C.H., Straus W.L., Morton S.C., Berger M.L., Et al., A metaanalysis of severe upper gastrointestinal complications of nonsteroidal antiinflammatory drugs, J Rheumatol, 29, pp. 804-812, (2002)
  • [5] Wolfe M.M., Lichtenstein D.R., Singh G., Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs, N Engl J Med, 340, pp. 1888-1899, (1999)
  • [6] Brun J., Jones R., Nonsteroidal anti-inflammatory drug-associated dyspepsia: The scale of the problem, Am J Med, 110, (2001)
  • [7] Lanas A., McCarthy D., Voelker M., Brueckner A., Senn S., Et al., Short-term acetylsalicylic acid (aspirin) use for pain, fever, or colds - Gastrointestinal adverse effects: A meta-analysis of randomized clinical trials, Drugs R D, 11, pp. 277-288, (2011)
  • [8] Sweeting M.J., Sutton A.J., Lambert P.C., What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data, Stat Med, 23, pp. 1351-1375, (2004)
  • [9] Breslow N.E., Day N.E., Statistical Methods in Cancer Research. Volume i - The Analysis of Case-control Studies, (1980)
  • [10] Tarone R.E., On heterogeneity tests based on efficient scores, Biometrika, 72, pp. 91-95, (1985)