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."