Dangers from NSAIDs: GI bleeds
NEW YORK (Reuters Health) Aug 24 - Approximately one third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of nonsteroidal anti-inflammatory agents (NSAIDs) or aspirin, results of a population-based observational study in Spain suggest. Up to one third of these incidences may be related to low-dose aspirin.
To estimate the mortality risk caused by GI complications from NSAID use, Dr. Angel Lanas, a gastroenterologist at University Hospital in Zaragoza, and his associates evaluated data from 2001 for 26 Spanish hospitals. Data included hospitalizations related to peptic-ulcer disease or complications such as bleeding or perforation, as well as drug use during the month prior to hospitalization.
They report their findings in the American Journal of Gastroenterology for August.
A total of 8010 serious GI events were reported, and among these, the mortality rate was 5.7%. Although hospitalizations were six times more likely to be due to upper GI complications rather than those in the lower GI tract, the percentage of deaths was similar (5.7% versus 5.3%, respectively).
The authors report that the proportion of complications and deaths attributed to NSAID and aspirin use was 36.3%. They also note that nearly 90% of deaths occurred in patients older than 60 years old.
To extrapolate the impact of aspirin and NSAID use on the general population of Spain, Dr. Lanas' group obtained data from 197 hospitals representative of all the hospitals in the Spanish National Health System.
Their results suggest that the mortality rate resulting from NSAID- or aspirin-related GI complications was between 21.0 and 24.8 cases per million inhabitants. This translates to 24.4 to 28.8 deaths per million prescriptions, and a maximum of 15.3 cases per 100,000 NSAID users.
The investigators note that mortality rates due to NSAID-associated GI events is similar to that for deaths associated with occupational activities, and is equivalent to more than 50% of AIDS deaths in 2001 in Spain.
According to the authors, these results highlight "the importance of taking ever-greater steps to research new and better alternatives to treat pain and inflammation in the elderly, to heighten physician and public awareness of the associated problems of NSAID therapy, and to educate them on the use of appropriate prevention strategies."
Dr. Byron Cryer, from the Dallas VA Medical Center, agrees with this conclusion. He writes in a related editorial: "Although clinically significant GI events with NSAIDs are uncommon, as a result of the vast numbers of patients who take these medications, when assessed by percentages these complications remain a significant public health concern."
Am J Gastroenterol 2005;100:1685-1695.
To estimate the mortality risk caused by GI complications from NSAID use, Dr. Angel Lanas, a gastroenterologist at University Hospital in Zaragoza, and his associates evaluated data from 2001 for 26 Spanish hospitals. Data included hospitalizations related to peptic-ulcer disease or complications such as bleeding or perforation, as well as drug use during the month prior to hospitalization.
They report their findings in the American Journal of Gastroenterology for August.
A total of 8010 serious GI events were reported, and among these, the mortality rate was 5.7%. Although hospitalizations were six times more likely to be due to upper GI complications rather than those in the lower GI tract, the percentage of deaths was similar (5.7% versus 5.3%, respectively).
The authors report that the proportion of complications and deaths attributed to NSAID and aspirin use was 36.3%. They also note that nearly 90% of deaths occurred in patients older than 60 years old.
To extrapolate the impact of aspirin and NSAID use on the general population of Spain, Dr. Lanas' group obtained data from 197 hospitals representative of all the hospitals in the Spanish National Health System.
Their results suggest that the mortality rate resulting from NSAID- or aspirin-related GI complications was between 21.0 and 24.8 cases per million inhabitants. This translates to 24.4 to 28.8 deaths per million prescriptions, and a maximum of 15.3 cases per 100,000 NSAID users.
The investigators note that mortality rates due to NSAID-associated GI events is similar to that for deaths associated with occupational activities, and is equivalent to more than 50% of AIDS deaths in 2001 in Spain.
According to the authors, these results highlight "the importance of taking ever-greater steps to research new and better alternatives to treat pain and inflammation in the elderly, to heighten physician and public awareness of the associated problems of NSAID therapy, and to educate them on the use of appropriate prevention strategies."
Dr. Byron Cryer, from the Dallas VA Medical Center, agrees with this conclusion. He writes in a related editorial: "Although clinically significant GI events with NSAIDs are uncommon, as a result of the vast numbers of patients who take these medications, when assessed by percentages these complications remain a significant public health concern."
Am J Gastroenterol 2005;100:1685-1695.
posted by Ricardo Pocurull at 9:18 AM
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