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Nonsteroidal anti-inflammatory drugs are associated with gastrointestinal (GI) damage. The Celecoxib vs. Omeprazole and Diclofenac for At-Risk Osteoarthritis and Rheumatoid Arthritis Patients (CONDOR) trial showed that a hemoglobin drop 2 g/dL or more adjudicated as either of defined or presumed GI origin was the most frequent component/event for the composite GI primary end point. This adverse event is potentially clinically relevant in long-term NSAID treatment. Professor Lanas and colleagues from Spain defined potential risk factors associated with a decrease in hemoglobin/hematocrit.
Post hoc analysis of the CONDOR trial was conducted in the intention-to-treat population.  | | 2% of osteoarthritis patients had decreased hemoglobin/hematocrit | | Alimentary Pharmacology & Therapeutics |
Clinically significant blood loss was defined as a hemoglobin drop 2 g/dL or more, and/or a hematocrit drop 10% or more, and blood loss adjudicated as either of defined or presumed GI origin. The researchers evaluated 15 risk factors ere evaluated by stepwise logistic regression. Each factor had to be significant at <0.20 α to be included in the model.
The research team found that a total of 2% of osteoarthritis patients had decreased hemoglobin/hematocrit, and were adjudicated to the GI endpoint. Significant risk factors, at the 0.20 α level found to be associated with clinically significant blood loss in osteoarthritis patients included baseline CRP levels, history of gastritis and history of GI intolerance, positive Helicobacter pylori at screening, increasing age, and body mass index.
Professor Lanas' team commented, "Monitoring for decreases in hemoglobin should be considered for all osteoarthritis patients and especially those with an increased age, BMI, history of gastritis and GI intolerance, CRP levels more than 1 mg/dL, and/or positive H. pylori status, as this may affect their clinical management."
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