Recent considerations in nonsteroidal anti-inflammatory drug gastropathy
Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NS...
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Veröffentlicht in: | The American journal of medicine 1998-07, Vol.105 (1), p.31S-38S |
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description | Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated. The Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) Post-Marketing Surveillance Program (PMS) has prospectively followed patient status and outcomes, drug side effects, and the economic impact of illness for >11,000 arthritis patients at 8 participating institutions in the United States and Canada. Analysis of these data indicates that: (1) osteoarthritis (OA) and rheumatoid arthritis (RA) patients are 2.5–5.5 times more likely than the general population to be hospitalized for NSAID-related GI events; (2) the absolute risk for serious NSAID-related GI toxicity remains constant and the cumulative risk increases over time; (3) there are no reliable warning signals— >80% of patients with serious GI complications had no prior GI symptoms; (4) independent risk factors for serious GI events were age, prednisone use, NSAID dose, disability level, and previous NSAID-induced GI symptoms; and (5) antacids and H
2 antagonists do not prevent NSAID-induced gastric ulcers, and high-risk NSAID users who take gastro-protective drugs are more likely to have serious GI complications than patients not taking such medications. Currently, limiting NSAID use is the only way to decrease the risk of NSAID-related GI events. Ongoing ARAMIS research is aimed at developing a simple point-score system for estimating individual risks of developing serious NSAID-related GI complications. |
doi_str_mv | 10.1016/S0002-9343(98)00072-2 |
format | Article |
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2 antagonists do not prevent NSAID-induced gastric ulcers, and high-risk NSAID users who take gastro-protective drugs are more likely to have serious GI complications than patients not taking such medications. Currently, limiting NSAID use is the only way to decrease the risk of NSAID-related GI events. Ongoing ARAMIS research is aimed at developing a simple point-score system for estimating individual risks of developing serious NSAID-related GI complications.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/S0002-9343(98)00072-2</identifier><identifier>PMID: 9715832</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Animals ; Antacids - therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal - adverse effects ; Biological and medical sciences ; Drug therapy ; Drug toxicity and drugs side effects treatment ; Histamine H2 Antagonists - therapeutic use ; Humans ; Medical sciences ; Pharmaceuticals ; Pharmacology. Drug treatments ; Risk Factors ; Side effects ; Stomach - drug effects ; Stomach Diseases - chemically induced ; Stomach Diseases - etiology ; Stomach Diseases - prevention & control ; Toxicity: digestive system</subject><ispartof>The American journal of medicine, 1998-07, Vol.105 (1), p.31S-38S</ispartof><rights>1998 Excerpta Medica Inc.</rights><rights>1998 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Jul 27, 1998</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5202-9506661c9361d2c1605b9dd7ec562d6e5e87f83fff740448e3d66e5a8e9ab6ac3</citedby><cites>FETCH-LOGICAL-c5202-9506661c9361d2c1605b9dd7ec562d6e5e87f83fff740448e3d66e5a8e9ab6ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0002-9343(98)00072-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2415715$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9715832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Singh, Gurkirpal</creatorcontrib><title>Recent considerations in nonsteroidal anti-inflammatory drug gastropathy</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated. The Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) Post-Marketing Surveillance Program (PMS) has prospectively followed patient status and outcomes, drug side effects, and the economic impact of illness for >11,000 arthritis patients at 8 participating institutions in the United States and Canada. Analysis of these data indicates that: (1) osteoarthritis (OA) and rheumatoid arthritis (RA) patients are 2.5–5.5 times more likely than the general population to be hospitalized for NSAID-related GI events; (2) the absolute risk for serious NSAID-related GI toxicity remains constant and the cumulative risk increases over time; (3) there are no reliable warning signals— >80% of patients with serious GI complications had no prior GI symptoms; (4) independent risk factors for serious GI events were age, prednisone use, NSAID dose, disability level, and previous NSAID-induced GI symptoms; and (5) antacids and H
2 antagonists do not prevent NSAID-induced gastric ulcers, and high-risk NSAID users who take gastro-protective drugs are more likely to have serious GI complications than patients not taking such medications. Currently, limiting NSAID use is the only way to decrease the risk of NSAID-related GI events. Ongoing ARAMIS research is aimed at developing a simple point-score system for estimating individual risks of developing serious NSAID-related GI complications.</description><subject>Animals</subject><subject>Antacids - therapeutic use</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Drug therapy</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Histamine H2 Antagonists - therapeutic use</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Pharmaceuticals</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>Side effects</subject><subject>Stomach - drug effects</subject><subject>Stomach Diseases - chemically induced</subject><subject>Stomach Diseases - etiology</subject><subject>Stomach Diseases - prevention & control</subject><subject>Toxicity: digestive system</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtLAzEQgIMotVZ_QmERD3pYzWOT3T2JFLVCQfBxDmkyWyNttiZZof_etF169TSZzDcPPoTGBN8STMTdO8aY5jUr2HVd3aSkpDk9QkPCOc9LIugxGh6QU3QWwndKcc3FAA3qkvCK0SGavoEGFzPdumANeBVtemXWZS7FCL61Ri0z5aLNrWuWarVSsfWbzPhukS1UiL5dq_i1OUcnjVoGuOjjCH0-PX5Mpvns9fll8jDLNafbYzgWQhBdM0EM1URgPq-NKUFzQY0ADlXZVKxpmrLARVEBMyL9qgpqNRdKsxG63M9d-_angxDld9t5l1ZKyigrKCvLBPE9pH0bgodGrr1dKb-RBMutPbmzJ7dqZF3Jnb3UP0Ljfng3X4E5dPW6Uv2qr6ug1bLxymkbDhgtCE9kwu73GCQRvxa8DNqC02CsBx2lae0_h_wBKL-Lmw</recordid><startdate>19980727</startdate><enddate>19980727</enddate><creator>Singh, Gurkirpal</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope></search><sort><creationdate>19980727</creationdate><title>Recent considerations in nonsteroidal anti-inflammatory drug gastropathy</title><author>Singh, Gurkirpal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5202-9506661c9361d2c1605b9dd7ec562d6e5e87f83fff740448e3d66e5a8e9ab6ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Animals</topic><topic>Antacids - therapeutic use</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Drug therapy</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Histamine H2 Antagonists - therapeutic use</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Pharmaceuticals</topic><topic>Pharmacology. Drug treatments</topic><topic>Risk Factors</topic><topic>Side effects</topic><topic>Stomach - drug effects</topic><topic>Stomach Diseases - chemically induced</topic><topic>Stomach Diseases - etiology</topic><topic>Stomach Diseases - prevention & control</topic><topic>Toxicity: digestive system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Singh, Gurkirpal</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Singh, Gurkirpal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recent considerations in nonsteroidal anti-inflammatory drug gastropathy</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>1998-07-27</date><risdate>1998</risdate><volume>105</volume><issue>1</issue><spage>31S</spage><epage>38S</epage><pages>31S-38S</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated. The Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) Post-Marketing Surveillance Program (PMS) has prospectively followed patient status and outcomes, drug side effects, and the economic impact of illness for >11,000 arthritis patients at 8 participating institutions in the United States and Canada. Analysis of these data indicates that: (1) osteoarthritis (OA) and rheumatoid arthritis (RA) patients are 2.5–5.5 times more likely than the general population to be hospitalized for NSAID-related GI events; (2) the absolute risk for serious NSAID-related GI toxicity remains constant and the cumulative risk increases over time; (3) there are no reliable warning signals— >80% of patients with serious GI complications had no prior GI symptoms; (4) independent risk factors for serious GI events were age, prednisone use, NSAID dose, disability level, and previous NSAID-induced GI symptoms; and (5) antacids and H
2 antagonists do not prevent NSAID-induced gastric ulcers, and high-risk NSAID users who take gastro-protective drugs are more likely to have serious GI complications than patients not taking such medications. Currently, limiting NSAID use is the only way to decrease the risk of NSAID-related GI events. Ongoing ARAMIS research is aimed at developing a simple point-score system for estimating individual risks of developing serious NSAID-related GI complications.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9715832</pmid><doi>10.1016/S0002-9343(98)00072-2</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Animals Antacids - therapeutic use Anti-Inflammatory Agents, Non-Steroidal - adverse effects Biological and medical sciences Drug therapy Drug toxicity and drugs side effects treatment Histamine H2 Antagonists - therapeutic use Humans Medical sciences Pharmaceuticals Pharmacology. Drug treatments Risk Factors Side effects Stomach - drug effects Stomach Diseases - chemically induced Stomach Diseases - etiology Stomach Diseases - prevention & control Toxicity: digestive system |
title | Recent considerations in nonsteroidal anti-inflammatory drug gastropathy |
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