Gastro-intestinal problems and concomitant medication in NSAID users: additional findings from a questionnaire-based survey in Italy

Silvani, Maria Chiara; Poluzzi, Elisabetta; Bottoni, Andrea; Ponti, Fabrizio De; Vaccheri, Alberto; Motola, Domenico

doi:10.1007/s00228-005-0078-7

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…Moreover, patient compliance was poor as reported elsewhere. 13 In this study, the number of patients who developed gastrointestinal symptoms due to chronic usage of NSAIDs were relatively high compared to the study conducted by Silvani et al 17 However, only a small number of the studied patients (10.8%) had taken the prescribed medication with gastro protective agents, either H2 antagonists or proton pump inhibitors (PPI).…”

Section: Discussionmentioning

confidence: 83%

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

Sulaiman¹,

Seung²,

Ismail³

2012

Oman Med J

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This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.

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Section: Discussionmentioning

confidence: 83%

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

Sulaiman¹,

Seung²,

Ismail³

2012

Oman Med J

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“…Using these criteria, many NSAID users have a risk factor, even if it is only age. A large US study found that 42% of 707,000 NSAID users were at higher risk [ 44 ], and in a recent Italian study at least one risk factor was found in 68% of NSAID users [ 51 ]. Many different guidelines exist, and they consistently recommend use of gastroprotective agent (PPI or H2A) with NSAID, or use of coxib.…”

Section: Discussionmentioning

confidence: 99%

Nonsteroidal anti-inflammatory drugs (NSAIDs), cyxlooxygenase-2 selective inhibitors (coxibs) and gastrointestinal harm: review of clinical trials and clinical practice

Moore

Derry

Phillips

et al. 2006

BMC Musculoskelet Disord

105

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BackgroundGastrointestinal harm, known to occur with NSAIDs, is thought to be lower with NSAID and gastroprotective agent, and with inhibitors selective to cyclooxygenase-2 (coxibs) at usual plasma concentrations. We examine competing strategies for available evidence of reduced gastrointestinal bleeding in clinical trials and combine this evidence with evidence from clinical practice on whether the strategies work in the real world, whether guidance on appropriate prescribing is followed, and whether patients adhere to the strategies.MethodsWe used a series of systematic literature searches to find full publications of relevant studies for evidence about the efficacy of these different gastroprotection strategies in clinical trials, and for evidence that they worked and were adhered to in clinical practice – whether they were effective. We chose to use good quality systematic reviews and meta-analyses when they were available.ResultsEvidence of efficacy of coxibs compared to NSAIDs for upper gastrointestinal bleeding was strong, with consistent reductions in events of about 50% in large randomised trials (34,460 patients), meta-analyses of randomised trials (52,474 patients), and large observational studies in clinical practice (3,093 bleeding events). Evidence on the efficacy of NSAID plus gastroprotection with acid suppressants (proton pump inhibitors, PPIs, and histamine antagonists, H2As) was based mainly on the surrogate measure of endoscopic ulcers. The limited information on damage to the bowel suggested that NSAID plus PPI was more damaging than coxibs.Eleven observational studies studied 1.6 million patients, of whom 911,000 were NSAID users, and showed that 76% (range 65% to 90%) of patients with at least one gastrointestinal risk factor received no prescription for gastroprotective agent with an NSAID. The exception was a cohort of US veterans with previous gastrointestinal bleeding, where 75% had gastroprotection with an NSAID. When gastroprotection was prescribed, it was often described as inadequate. A single study suggested that patient adherence to prescribed gastroprotection was low.ConclusionEvidence for efficacy of gastroprotection strategies with NSAIDs is limited. In clinical practice few patients who need gastroprotection get it, and those who get it may not take it. For coxibs, gastroprotection is inherent, although probably not complete.

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“…However, postoperative nausea and vomiting incidence were lower in dexketoprofen (21%) group compared with ketoprofen (34%) and placebo (47%). 25,26 None of our patients had side effects such as gastric pain, heartburn, dizziness, or itching. The difference may be due to the administration route of the drug and different surgical procedures.…”

Section: Discussionmentioning

confidence: 69%

Postoperative Analgesic Efficacy of Intravenous Dexketoprofen in Lumbar Disc Surgery

Yazar

İnan

Ceyhan

et al. 2011

Journal of Neurosurgical Anesthesiology

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Gastro-intestinal problems and concomitant medication in NSAID users: additional findings from a questionnaire-based survey in Italy

Cited by 12 publications

References 18 publications

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

Nonsteroidal anti-inflammatory drugs (NSAIDs), cyxlooxygenase-2 selective inhibitors (coxibs) and gastrointestinal harm: review of clinical trials and clinical practice

Postoperative Analgesic Efficacy of Intravenous Dexketoprofen in Lumbar Disc Surgery

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