Outcome of peptic ulcer bleeding among users of traditional non‐steroidal anti‐inflammatory drugs and selective cyclo‐oxygenase‐2 inhibitors

Abstract

SUMMARY BackgroundFew data exist on the impact of non-steroidal anti-inflammatory drug use on peptic ulcer outcome.

Mortality from peptic ulcer bleeding: the impact of comorbidity and the use of drugs that promote bleeding

“…However, aspirin, non‐aspirin NSAIDs and warfarin did not increase the risk of fatal outcome in this study, which is similar to findings reported by others, 10–12, 22, 23 although in contrast with two studies 24, 25 . Aspirin use at admission was, in our study, even found to reduce the risk of in‐hospital mortality, which is consistent with the results of a recently published randomized trial 26 where patients after endoscopic haemostasis of a PUB were given low‐dose aspirin or placebo for 8 weeks.…”

Chronic liver disease and 90-day mortality in 21 359 patients following peptic ulcer bleeding - a Nationwide Cohort Study

“…The Danish National Health Service Prescription Registry contains information on all redeemed prescriptions for reimbursed medications in Denmark . We ascertained current use (defined as at least one redeemed prescription within 90 days of the current hospitalisation) of histamine‐2 receptor antagonists, prostaglandin analogues, proton pump inhibitors, non‐steroidal anti‐inflammatory drugs (NSAIDs), systemic glucocorticoids, acetaminophen, aspirin, vitamin‐K antagonists, antidepressants and antipsychotic drugs (for specific Anatomical Therapeutic Chemical classification system codes, see Appendix S1) …”

“…28 We ascertained current use (defined as at least one redeemed prescription within 90 days of the current hospitalisation) of histamine-2 receptor antagonists, prostaglandin analogues, proton pump inhibitors, non-steroidal anti-inflammatory drugs (NSA-IDs), systemic glucocorticoids, acetaminophen, aspirin, vitamin-K antagonists, antidepressants and antipsychotic drugs (for specific Anatomical Therapeutic Chemical classification system codes, see Appendix S1). 32,[35][36][37][38][39][40] Mortality data We followed patients from date of hospital admission with peptic ulcer bleeding until death, emigration, or up to 90 days or end of study, whichever came first. Data on all-cause mortality were obtained from the Danish Civil Registration System, which contains records of changes in migration and vital status for the entire Danish population since 1968, electronically updated on a daily basis.…”

National mortality following upper gastrointestinal or cardiovascular events in older veterans with recent nonsteroidal anti‐inflammatory drug use

“…estimated that 15.3 deaths per 100 000 patients occur in a Spanish population following upper and lower gastrointestinal events 1 . In an elderly Danish population, 30‐day mortality was 13% among current NSAID users, with the highest 30‐day adjusted mortality rate ratio (MRR) among patients following peptic ulcer bleeding (MRR 1.4; 1.1–1.9) 2 and peptic ulcer perforation (MRR 1.8; 95% CI: 1.4–2.3) 3 …”