NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND GASTROINTESTINAL HOSPITALIZATIONS IN SASKATCHEWAN - A COHORT STUDY

被引：78

作者：

RODRIGUEZ, LAG

WALKER, AM

GUTTHANN, SP

机构：

[1] Pharmacoepidemiology Unit Basel, CIBA-GEIGY A.G., Basel

[2] Department of Epidemiology, Harvard University School of Public Health, Boston, MA

来源：

EPIDEMIOLOGY | 1992年 / 3卷 / 04期

关键词：

NONSTEROIDAL ANTIINFLAMMATORY AGENTS; DICLOFENAC; INDOMETHACIN; NAPROXEN; PIROXICAM; SULINDAC; GASTROINTESTINAL TOXICITY; PHARMACOEPIDEMIOLOGY; MEDICAL RECORD LINKAGE;

D O I：

10.1097/00001648-199207000-00008

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

We evaluated the association between individual nonsteroidal antiinflammatory drugs (NSAIDs) and gastrointestinal (GI) toxicity in a retrospective cohort study aimed at examining and comparing the incidence of serious gastrointestinal disorders among NSAIDs users. We observed 2,302 GI hospitalizations among diclofenac, indomethacin, naproxen, piroxicam, sulindac, and other NSAIDs users in the province of Saskatchewan, Canada, from 1982 to 1986 for 228,392 persons who contributed 679,075 person-years of follow-up and filled close to 1.5 million NSAID prescriptions. Current NSAID users presented an increased risk of GI hospitalization [rate ratio (RR) = 3.9, 95% confidence interval = 3.5-4.4]. RRs decreased as time since the last prescription increased: 2.2 (1.9-2.6) for recent past users and 1.3 (1.1-1.5) for less recent past users. Among current users, RRs were the highest in indomethacin users (5.1, 4.3-6.0), and the lowest in sulindac users (3.1, 2.3-4.2). All of these results are adjusted for calendar time, sex, and age. Age showed a particularly strong association with the risk of GI hospitalization.

引用

页码：337 / 342

页数：6

共 24 条

[1] Avorn J., Reporting drug side effects: Signals and noise (Editorial), JAMA, 263, (1990)
[2] Caruso I., Bianchi Porro G., Gastroscopic evaluation of antiinflammatory agents, Br Med J, 280, pp. 75-78, (1980)
[3] Day R.O., Brooks P.M., Variations in response to non-steroidal anti-inflammatory drugs, Br J Clin Pharmacol, 23, pp. 655-658, (1987)
[4] Pullar T., Murphy B., Taggart A., Wright V., Patterns of outpatient non-steroidal anti-inflammatory drug prescribing in two teaching hospital rheumatology units: Implications for postmarketing surveillance, J Clin Pharm Ther, 15, pp. 267-272, (1990)
[5] Beard K., Walker A.M., Perera D., Jick H., Non-steroidal antiinflammatory drugs and hospitalization for gastroesophageal bleeding in the elderly, Arch Intern Med, 147, pp. 1621-1623, (1987)
[6] Guess H.A., West R., Strand L.M., Helston D., Lydick E.G., Bergman U., Wolski K., Fatal upper gastrointestinal hemorrhage or perforation among users and nonusers of anti-inflammatory drugs in Saskatchewan, Canada, 1983, J Clin Epidemiol, 41, pp. 35-45, (1988)
[7] Sommerville K., Faulkner G., Langman M., Non-steroidal antiinflammatory drugs and bleeding peptic ulcer, Lancet, 1, pp. 462-464, (1986)
[8] Armstrong C.P., Blower A.L., Non-steroidal anti-inflammatory drugs and life-threatening complications of peptic ulcerations, Gut, 28, pp. 527-532, (1987)
[9] Caradoc-Davies T.H., Non-steroidal anti-inflammatory drugs, arthritis, and gastrointestinal bleeding in elderly inpatients, Age Ageing, 13, pp. 295-298, (1984)
[10] Bollini P., Garcia Rodriguez L.A., Perez Gutthann S., Walker A.M., The impact of research quality and study design on epidemiologic estimates of the effect of NSAIDs on upper gastrointestinal pathology, Arch Intern Med, 152, pp. 1289-1295, (1992)

← 1 2 3 →