https://scholars.lib.ntu.edu.tw/handle/123456789/189938
標題: | Non-steroidal anti-inflammatory drugs use and risk of upper gastrointestinal adverse events in cirrhotic patients | 作者: | Lee, Yen-Chieh CHIA-HSUIN CHANG JOU-WEI LIN Chen, Hsi-Chieh Lin, Min-Shung Lai, Mei-Shu |
關鍵字: | anti-inflammatory agents;celecoxib;cirrhosis;gastrointestinal haemorrhage;non-steroidal;variceal bleeding | 公開日期: | 2012 | 卷: | 32 | 期: | 5 | 起(迄)頁: | 859-866 | 來源出版物: | Liver International | 摘要: | Background/Aims: The upper gastrointestinal (GI) toxicity associated with non-steroidal anti-inflammatory drugs (NSAID) use among cirrhotic patients remains unclear. The objective of this study was to evaluate the risk of upper GI adverse events associated with celecoxib and oral and parenteral non-selective NSAIDs in cirrhotic patients. Methods: All the patients aged >= 20 years with a diagnosis of cirrhosis hospitalized for variceal bleeding and non-variceal upper GI adverse events (oesophageal, gastric, duodenal ulcer, bleeding; gastritis and duodenitis) in 2006 were identified using ICD9- CM diagnosis codes from inpatient claims from the Taiwan National Health Insurance Database. In the case-crossover study design, the case period was defined as 1-30 days and the control period as 31-60 days before the date of hospitalization. The information for individual NSAID use was obtained from the outpatient pharmacy prescription database. Adjusted selfmatched odds ratios (OR) and their 95% confidence intervals (CI) were estimated with a conditional logistic regression model. Results: A total of 4876 cirrhotic patients were included. The adjusted OR (95% CI) was 1.44 (0.892.31) for celecoxib, 1.87 (1.66-2.11) for oral non-selective NSAIDs and 1.90 (1.55-2.32) for parenteral NSAIDs overall. Risks were similar for variceal and non-variceal events. Concomitant use of proton pump inhibitors and histamine- 2 receptor antagonists tended to decrease the upper GI toxicity associated with non-selective NSAIDs and celecoxib. Conclusion: The use of nsNSAIDs but not celecoxib was associated with a two-fold increased risk of variceal and non-variceal upper GI events among cirrhotic patients. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/258815 http://ntur.lib.ntu.edu.tw/bitstream/246246/258815/1/index.html |
DOI: | 10.1111/j.1478-3231.2011.02739.x | SDG/關鍵字: | acemetacin; acetylsalicylic acid; celecoxib; corticosteroid; histamine H2 receptor antagonist; ibuprofen; ketorolac; mefenamic acid; nitrate; nonsteroid antiinflammatory agent; proton pump inhibitor; adult; aged; article; case study; disease association; drug use; duodenitis; female; gastritis; gastrointestinal hemorrhage; gastrointestinal symptom; gastrointestinal variceal bleeding; human; liver cirrhosis; major clinical study; male; peptic ulcer; peptic ulcer bleeding; retrospective study; upper gastrointestinal tract; varicosis; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Comorbidity; Cyclooxygenase 2 Inhibitors; Databases, Factual; Duodenitis; Esophageal and Gastric Varices; Female; Gastritis; Gastrointestinal Diseases; Histamine Antagonists; Humans; Liver Cirrhosis; Logistic Models; Male; Middle Aged; Peptic Ulcer; Proton Pump Inhibitors; Pyrazoles; Risk Assessment; Sulfonamides; Young Adult |
顯示於: | 醫學系 |
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