NSAIDs plus aspirin increases GI bleeds, complications

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NSAIDs plus aspirin increases GI bleeds, complications



Oct 31, 2005



Janis





" The message to all physicians is to be sure to query patients about

OTC NSAID usage (including aspirin) when taking a medication history. "



Honolulu, HI- Patients who combine common over-the-counter (OTC)

nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or

naproxen, with aspirin double or triple their risk of serious

gastrointestinal (GI) complications, including ulcers, perforations,

and GI bleeds, Dr ph Biskupiak (University of Utah, Salt Lake

City) reported at the American College of Gastroenterology (ACG) 70th

Annual Scientific Meeting [1].

" The message to all physicians is to be sure to query patients about

OTC NSAID usage (including aspirin) when taking a medication history.

The message is the same for patients—that OTC NSAIDs are drugs that

have risks associated with them, and they need to talk with their

physician if they are taking these meds chronically, " Biskupiak tells

rheumawire.

Even OTC doses of NSAIDs associated with increased risk

Biskupiak and colleagues at the University of Utah and at Pfizer,

Inc. (New York City, NY) used data from GE Medical System's

Centricity database, which has collected data on more than 3 million

individuals, to examine the interactions of ibuprofen, naproxen, and

aspirin. The analysis presented at the ACG meeting included 11 957

subjects taking naproxen (220 mg) and 38 507 taking ibuprofen (200

mg). Concomitant aspirin usage was reported by 2328 naproxen subjects

and 4843 ibuprofen subjects.

The analysis excluded patients who took steroids, used blood thinners

such as warfarin, or had other significant health problems. The data

were analyzed for concomitant aspirin use and perforations, ulcers,

or bleeds (PUBs). The researchers conducted a pre/post analysis using

a case-crossover design, and subjects were their own controls. The

index date was the defining event, and odds ratios were evaluated for

PUBs at 180 and 365 days.

" Subjects taking both ibuprofen and aspirin had an odds ratio of 3.36

(2.36 to 4.80, p<0.00001) for PUBs relative to those on ibuprofen

alone. Those on naproxen and aspirin had an odds ratio of 2.07

relative to those on naproxen alone, " Biskupiak said.

Without aspirin and at the OTC doses used, ibuprofen and naproxen

were associated with a risk of PUBs more than 2 times higher.

" Even at OTC doses, ibuprofen and naproxen are associated with

increased risk of serious GI events. Concomitant aspirin use can

significantly increase such risk, " Biskupiak concluded.

Biskupiak J, Brixner D, Oderda G, et al. Gastrointestinal

complications of over-the-counter non-steroidal anti-inflammatory

drugs. American College of Gastroenterology 70th Annual Scientific

Meeting; Oct 30-Nov 2, 2005; Honolulu, HI.