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News

Gastrointestinal events with the use of various NSAIDs

Researchers investigate the risk of upper gastrointestinal events with the use of various NSAIDs in August's issue of the Scandinavian Journal of Gastroenterology.

News image

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The gastrointestinal safety of different non-steroidal anti-inflammatory drugs (NSAIDs) in a real-life setting remains ill defined.

Dr Arja Helin-Salmivaara and colleagues from Finland examined the risk of upper gastrointestinal (GI) events associated with various non-steroidal anti-inflammatory drugs in a general population.

A nationwide, register-based, matched case-control study was carried out in outpatient residents of Finland in 2000 to 2004.

The adjusted odds ratio was 1.5 for semi-selective NSAIDs
Scandinavian Journal of Gastroenterology

The team drew 9191 cases with upper GI events from the Hospital Discharge Register, and individually matched them to 41,780 controls from the Population Register.

The researchers found the semi-selective NSAIDs (nimesulide, nabumetone, meloxicam, etodolac) had the highest odds ratio for upper GI events.

This was followed by non-selective, and COX-2 selective non-steroidal anti-inflammatory drugs.

The team then compared the current use of semi-selective NSAIDs with that of non-selective and COX-2 selective NSAIDs.

The researchers found that the adjusted odds ratio was 1.5 for semi-selective NSAIDs and 1.7 for the COX-2 selective NSAIDs.

The researchers observed that the adjusted odds ratio for the use of COX-2 selective NSAIDs did not differ statistically from the non-selective NSAIDs.

The adjusted odds ratios for individual NSAIDs varied across and within categories.

Dr Helin-Salmivaara's team concluded, "As a group, the gastrointestinal safety of the COX-2 selective NSAIDs was not demonstrated as definitively superior to non-selective NSAIDs."

"Semi-selective NSAIDs do not seem to offer any gastrointestinal advantage over other NSAIDs."

Scand J Gastroenterol 2007: 42(8): 923-32
27 July 2007

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