Healthy Skepticism Library item: 15130

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Publication type: Journal Article

Herxheimer A.
Many NSAID users who bleed don't know when to stop.
BMJ. 1998 Feb 14; 316:(7130):492
http://www.bmj.com/cgi/content/abstract/316/7130/492

Abstract:

Uncomprehending “adherence” is dangerous
Upper gastrointestinal bleeding and perforation are common and serious adverse effects of non-steroidal anti-inflammatory drugs. About a third of all ulcer bleeding in older people is associated with these drugs ; the same may apply to perforation. The most important predisposing influences are the type and dose of drug (and use of two non-steroidal anti-inflammatory agents together), which can increase the risk up to 20-fold. Other risk factors include prior ulcer, anticoagulants, systemic corticosteroids, smoking, alcohol consumption, and old age. Some of these are independent, so that treatment with non-steroidal anti-inflammatory drugs increases an already high risk. As we look for ways of lowering the risk of bleeding in patients using non-steroid anti-inflammatory drugs, an ingenious investigation from Newcastle offers a new lead.

Keywords:
Anti-Inflammatory Agents, Non-Steroidal/adverse effects* Gastrointestinal Hemorrhage/chemically induced* Humans Patient Compliance* Patient Education as Topic Risk Factors Stomach Diseases/chemically induced*