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Titolo:
Relative risk of upper gastrointestinal complications among users of acetaminophen and nonsteroidal anti-inflammatory drugs
Autore:
Rodriguez, LAG; Hernandez-Diaz, S;
Indirizzi:
CEIFE, Madrid 28004, Spain CEIFE Madrid Spain 28004CEIFE, Madrid 28004, Spain Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 th, Dept Epidemiol, Boston, MA 02115 USA
Titolo Testata:
EPIDEMIOLOGY
fascicolo: 5, volume: 12, anno: 2001,
pagine: 570 - 576
SICI:
1044-3983(200109)12:5<570:RROUGC>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTIINFLAMMATORY DRUGS; TOXICITY; ULCERS; METAANALYSIS; PERFORATION; MISOPROSTOL; VARIABILITY; ANALGESICS; OMEPRAZOLE; IMPACT;
Keywords:
nonsteroidal anti-inflammatory drugs; acetaminophen; nitrates; gastrointestinal hemorrhage; gastrointestinal toxicity; peptic ulcer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Rodriguez, LAG CEIFE, Almirante 28-2, Madrid 28004, Spain CEIFE Almirante 28-2 Madrid Spain 28004 adrid 28004, Spain
Citazione:
L.A.G. Rodriguez e S. Hernandez-Diaz, "Relative risk of upper gastrointestinal complications among users of acetaminophen and nonsteroidal anti-inflammatory drugs", EPIDEMIOLOG, 12(5), 2001, pp. 570-576

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with anincrease in upper gastrointestinal complications. There is no agreement, however, on whether all conventional NSAIDs have a similar relative risk (RR), and epidemiologic data are Limited on acetaminophen. We studied the association between these medications and the risk of upper gastrointestinal bleed/perforation in a population-based cohort of 958,397 persons in the United Kingdom between 1993 and 1998. Our nested case-control analysis included2,105 cases and 11,500 controls. RR estimates were adjusted for several factors known to be associated with upper gastrointestinal bleed/perforation. Compared with non-users, users of acetaminophen at doses less than 2 gm did not have an increased risk of upper gastrointestinal complications. The adjusted RR for acetaminophen at doses greater than 2 gm was 3.6 [95% confidence interval (95% CI) = 2.6-5.1]. The corresponding RRs for low/medium andhigh doses of NSAIDs were 2.4 (95% CI = 1.9-3.1) and 4.9 (95% CI = 4.1-5.8). The RR was 3.1 (95% CI = 2.5, 3.8) for short plasma half-life, 4.5 (95% Ci = 3.5-5.9) for long half-life, and 5.4 (95% CI = 4.0-7.1) for slow-release formulations of NSAIDs. After adjusting for daily dose, the differences in RR between individual NSAIDs tended to diminish except for apazone. Users of H-2 receptor antagonists, omeprazole, and misoprostol had RRs of 1.4 (95% CI = 1.2-1.8), 0.6 (95% CI = 0.4-0.9), and 0.6 (95% CI = 0.4-1.0), respectively. Among NSAID users, use of nitrates was associated with an RR of 0.6 (95% CI = 0.4-1-0).

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Documento generato il 01/04/20 alle ore 11:38:21