Cross-Sectional Study for Prevalence of Non-Steroidal Anti-Inflammatory Drug-Induced Gastrointestinal, Cardiac and Renal Complications in India: Interim Report

Abstract

BackgroundNon-steroidal anti-inflammatory drugs (NSAIDs) are the most common therapeutic products used for the management of inflammation and pain. However, their use is associated with gastrointestinal (GI), cardiovascular and renal complications. Although prevalence data regarding NSAID-induced complications are available worldwide, but none of the study has assessed the prevalence of GI, cardiac and renal complications in India. This study aimed to assess the point prevalence of GI, cardiac and renal complications associated with the use of NSAIDs in India. The study also aimed to evaluate the association between the risk factors and GI, renal and cardiac complications in patients using NSAIDs.MethodsThis prospective, cross-sectional, multi-centric study was conducted in eight medical colleges across India (North, East, West, South and Central India). Data related to GI complications including gastric, duodenal and gastroduodenal erosions/ulcers/gastritis, renal complications including acute and chronic renal failure or cardiac complications including acute coronary syndrome (ACS), acute myocardial infarction (AMI) and cardiac failure, were collected from patients.ResultsThe cut-off date for interim data analysis was July 7, 2014. A total of 2,140 patients out of 3,600 were enrolled from eight centers at the time of interim analysis. The NSAID-associated point prevalence of GI complications was 30.08%; cardiac complication was 42.77%; and renal complication was 27.88%.ConclusionsResults of the present interim analysis show that the prevalence of GI, cardiac and renal complications among patients is high due to exaggerated usage; however, the final analysis would provide the overall prevalence of these complications.

Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective

“…Prevalence of gastric mucosal lesions has been observed in patients, with rheumatoid arthritis or pain, who have taken NSAIDs [110][111]. A prospective, cross-sectional multi-centred study in India, which included 8 medical colleges across the country, reported NSAID-related GI complications in 30.08% cases [112]. In a study performed in Pakistan, analysing 820 patients who have undergone upper gastrointestinal (GI) endoscopy (1998)(1999)(2000), it was found that 14.7% patients reflected NSAIDs-related peptic ulcer.…”

“…Notably, duodenal ulcer (65.3%) was found more frequently than gastric ulcer (42.3%) [111]. In all the cases the duration and dose of NSAID usage were the major determinants of the severity of complications [112]. The risk of GI complications by NSAIDs increases by 2.5-5.0% in patients with a previous history of GI incidents [113].…”

A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy

“…Injectable methylcobalamin was registered as a 500 µg unit dose ampule and recommended in a regimen of one injection every other day. This thrice weekly recommendation was in accordance with the prescription information provided by the innovator, Eisai pharmaceuticals, Japan [ 15 ]. Lately, there are higher dose ampoules of 1500 mcg available, which claim to replace the 3 weekly injections with just one.…”

The impact of pharmaceutical care on the efficacy and safety of transdermal glucosamine sulfate and capsaicin for joint pain

“…Despite the widespread use of these medications to treat various pain types, they are associated with many adverse effects. The latter are dependent on the duration of NSAIDs therapy [2,3]. Due to safety concerns, there is an urgent need to find effective and safe alternative pain treatments, especially for chronic pain.…”