Upper gastrointestinal bleeding and the changing use of COX‐2 non‐steroidal anti‐inflammatory drugs and low‐dose aspirin

Taha, A S; Angerson, Wilson J.; Prasad, Rajendra; McCloskey, Caroline; Blatchford, Oliver

doi:10.1111/j.1365-2036.2007.03458.x

Cited by 33 publications

(48 citation statements)

References 21 publications

(42 reference statements)

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“…Despite the numerous studies describing the gastrointestinal (GI) side effects of NSAIDs, they continue to be the drugs that are most commonly used in the vast majority of painful conditions. NSAIDs are generally well tolerated, but patients and clinicians continue to face the significant challenge of their serious GI complications, including bleeding, perforation, and occasionally death [1]. In almost all volunteers challenged with aspirin, mild haemorrhagic gastropathy involving the proximal or entire stomach develops within 24 h. The bleeding associated with this acute damage is minimal and only rarely clinically apparent.…”

Section: Introductionmentioning

confidence: 98%

The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage

Paşa

Bayan

Küçüköner

et al. 2008

J Thromb Thrombolysis

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Nonsteroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal (GI) damage primarily due to the inhibition of prostaglandin synthesis in gastric mucosa, which is an important factor in mucosa protection. Platelets are a cardinal feature of vascular repair. A variety of angiogenic stimulators are stored in platelets and are released during clotting at the wound. When there is a defect in any of these functions and/or platelet number, haemostasis is usually impaired and there may be an associated increased risk and severity of bleeding. While the mechanism of mucosal injury and bleeding are well documented with the use of NSAIDs, very little is known about the platelet function abnormalities and their effects on severity of upper GI bleedings. We performed a prospective analysis of 49 patients who had a history of NSAIDs use to investigate the association between the platelet function impairment associated with NSAIDs and severity of upper GI haemorrhages. Thirty-six of 49 patients (73.5%) had deteriorated platelet function. Mean severity score of patients with deteriorated platelet functions was 3.39, and that of patients with normal platelet functions was 2.46. Mean severity score was statistically significantly higher in patients with deteriorated platelet functions. In conclusion, impaired platelet functions associated with NSAIDs may cause more severe upper GI bleeding. Clinicians should be alert for GI complications especially in older patients and in those with a history of ulcer bleeding.

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Section: Introductionmentioning

confidence: 98%

The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage

Paşa

Bayan

Küçüköner

et al. 2008

J Thromb Thrombolysis

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“…[8][9][10][11][12][13][14][15][16][17] Indeed, peptic ulcers have been shown to occur among patients with increased GI risk taking ASA daily, within the dose range of 75-100 mg daily. [18] In turn, peptic ulcers may lead to serious complications, including upper GI bleeding, perforation, and gastric outlet obstruction.…”

Section: Introductionmentioning

confidence: 99%

Impact of Gastrointestinal Problems on Adherence to Low-Dose Acetylsalicylic Acid

Moberg

Næsdal

Svedberg

et al. 2011

The Patient: Patient-Centered Outcomes Research

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“…Recent evidence also suggests that the increasing incidence of upper gastrointestinal bleeding could be accounted for by the widespread and increasing use of low-dose ASA 9,46,47 . Over the last 10 years, for example, the incidence of upper gastrointestinal bleeding attributed to low-dose ASA has increased 3-fold in south-west Scotland 47 .…”

Section: Clinical Evidence Of Low-dose Asa-induced Gastroduodenal Toxmentioning

confidence: 96%

“…Over the last 10 years, for example, the incidence of upper gastrointestinal bleeding attributed to low-dose ASA has increased 3-fold in south-west Scotland 47 . Additionally, a number of patientrelated risk factors increase the risk of upper gastrointestinal complications among patients receiving low-dose ASA.…”

Section: Clinical Evidence Of Low-dose Asa-induced Gastroduodenal Toxmentioning

confidence: 99%

Gastroduodenal toxicity of low-dose acetylsalicylic acid: a comparison with non-steroidal anti-inflammatory drugs

Yeomans

Hawkey

Brailsford

et al. 2009

Current Medical Research and Opinion

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Data suggest that ASA causes significant gastroduodenal damage even at the low doses used for cardiovascular protection. These effects (both systemic and possibly local) may be pharmacodynamically distinct from the gastroduodenal toxicity seen with NSAIDs. Studies are required to establish strategies for improving the tolerability of low-dose ASA, allowing patients to continue to benefit from the cardiovascular protection associated with such therapy.

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Upper gastrointestinal bleeding and the changing use of COX‐2 non‐steroidal anti‐inflammatory drugs and low‐dose aspirin

Abstract: SUMMARY BackgroundRofecoxib was withdrawn in 2004.

Cited by 33 publications

References 21 publications

The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage

The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage

Impact of Gastrointestinal Problems on Adherence to Low-Dose Acetylsalicylic Acid

Gastroduodenal toxicity of low-dose acetylsalicylic acid: a comparison with non-steroidal anti-inflammatory drugs

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