Upper gastrointestinal complications are a well-recognized risk of non-steroidal anti-inflammatory drug (NSAID) treatment, requiring preventive measures in high-risk patients.
Adherence to gastroprotective agents in NSAID users has been suggested to be suboptimal.
Dr Van Soest and colleagues from the Netherlands investigated the association between adherence to gastroprotective agents and the risk of NSAID-related upper gastrointestinal ulcers or hemorrhage in high-risk patients.
|15% of the non-selective NSAID users received gastroprotective agents|
|Alimentary Pharmacology & Therapeutics|
The team conducted a population-based nested case-control study within a cohort of new NSAID users between 1996 and 2005.
The patients had at least 1 risk factor for a NSAID-related upper gastrointestinal complication.
Adherence to gastroprotective agents was calculated as the proportion of NSAID treatment days covered by a gastroprotective agent prescription (PDC).
Multivariate conditional logistic regression analysis was used to calculate odds ratios with 95% confidence intervals.
The researchers found that 15% of the non-selective NSAID users received gastroprotective agents.
The risk of a NSAID-related upper gastrointestinal complication among NSAID users increased 16% for every 10% decrease in adherence, compared to patients with a PDC of more than 80%.
Patients with PDCs of 20% to 80%, and less than 20% had a 2.5-fold and 4-fold increased risk, respectively.
Dr Van Soest's team concluded, "There is a strong inverse relationship between adherence to gastroprotective agents and the risk of upper gastrointestinal complications in high-risk NSAID users."