Risk for serious gastrointestinal complications related to use of nonsteroidal anti-inflammatory drugs: a meta-analysis

Article Abstract:

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used compounds prescribed (and purchased over-the-counter) for the treatment of inflammation-mediated pain (such as musculoskeletal and arthritic syndromes). Use of these compounds has been linked to mild gastrointestinal symptoms such as dyspepsia (discomfort during digestion), and more severe symptoms such as bleeding and perforation of the wall of the gastrointestinal tract, and other events leading to hospitalization or death. To determine the relative risk of gastrointestinal complications among NSAID users, an analysis was done of English-language studies published between 1975 and 1990. A search was done of the MEDLINE computer data base that yielded 142 relevant articles (from an initial group of 526 flagged by the computer search strategy). The odds ratio for developing serious gastrointestinal events based on 16 studies extracted from this group of articles was 2.74, that is, NSAID users were 2.74 times more likely than nonusers to develop such complications. The odds ratios for selected subgroups of NSAID users were: over 60 years of age (5.52), under 65 years of age (1.65), women (2.32), men (2.40). NSAID users receiving concomitant corticosteroids (steroidal anti-inflammatory drugs) were 1.83 times more likely to suffer from adverse gastrointestinal events than those receiving only NSAIDs. The NSAID-augmented risk for undergoing a first gastrointestinal complication was much less than the risk for patients who had previously suffered such an event. As duration of treatment increases, the likelihood of complications occurring diminishes (in the absence of any prior complications). (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Gastrointestinal bleeding, Gastrointestinal hemorrhage

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Misoprostol and nonsteroidal anti-inflammatory drugs: a tale of effects, outcomes, and costs

Article Abstract:

Misoprostol may only have limited usefulness in preventing recurring stomach and intestinal complications in patients with rheumatoid arthritis taking nonsteroidal anti-inflammatory drugs (NSAIDS). Researchers reported that misoprostol given to older rheumatoid arthritis patients had less stomach and intestinal tearing and fewer recurring bleeding episodes than those patients taking a placebo. A preliminary cost analysis shows that preventive misoprostol treatment may be 6.5 times more cost-effective than no treatment. However, there may be other courses of treatment that should be considered before prescribing misoprostol such as reducing the NSAID dose or replacing it with another medication. Misoprostol may be an appropriate course of treatment for older patients with rheumatoid arthritis and a history of ulcers and heart disease.

Care and treatment, Editorial, Evaluation, Drug therapy, Arthritis, Gastrointestinal diseases, Misoprostol

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The incidence of giant cell arteritis in Olmsted County, Minnesota: apparent fluctuations in a cyclic pattern

Article Abstract:

An infection may cause giant cell arteritis. Giant cell arteritis is a progressive inflammatory disease of the blood vessels in the head. Infectious diseases generally occur with cyclic frequencies. Researchers tabulated the county-wide frequency trends of giant cell arteritis over a period of 42 years. The number of cases of giant cell arteritis fluctuated over time in a cyclical pattern. Peaks in the number of cases lasted about 3 years. The peaks occurred about every 7 years. The number of reported cases of giant cell arteritis increased over time. Giant cell arteritis occurred most frequently in persons older than 70 and in women.

Analysis, Demographic aspects, Cycles, Giant cell arteritis, Temporal arteritis

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