Recommendations for the appropriate use of anti-inflammatory drugs in the era of the coxibs: SCOPE OF N SAID-AS SOCIATED GASTROINTESTINAL TOXICITY Part 3


MortalityData on the excess gastrointestinal mortality associated with conventional NSAID use are limited. The ARAMIS database reported an annual mortality rate of 0.22% in patients suffering from rheumatoid arthritis who were taking conventional NSAIDs compared with 0.05% in those who were not taking NSAIDs. However, the background mortality rate in patients with rheumatoid arthritis is likely to be higher than that of the general population. A Canadian report estimated that 1900 deaths each year are attributable to NSAID consumption, which exceeds the number of deaths ascribed to motor vehicle accidents. This incidence is consistent with the estimated NSAID-related mortality rate in the United States of 16,500 deaths annually. Best quality drugs are waiting – buy yasmin online to spend less time and money.

Most studies of risk factors of peptic ulcer disease associated with NSAID use have been case-control studies in which relative risk was calculated. In practice, absolute event rates are more relevant. The Vioxx Gastrointestinal Outcomes Research (VIGOR) study — a prospective, randomized study (vide infra) — allowed for the calculation of relative and absolute risk; age and previous gastrointestinal history were confirmed to be significant risk factors. In patients taking naproxen, the absolute annual risk of having a clinically important gastrointestinal event was 19% for those with a previous gastrointestinal complication and 14% for those older than 75 years of age.

This entry was posted in Coxibs and tagged Coxibs, Cyclooxygenase-2 inhibitors, Gastroprotective agents, Nonsteroidal anti-inflammatory drugs.