Why the study?
Does the use of COX-2 selective NSAIDs or gastroprotective cotherapy reduce the risk of gastrointestinal injury in patients taking NSAIDs or low-dose aspirin?
Population
Populations with varying risk characteristics using nonsteroidal antiinflammatory drugs and/or low-dose…
Comparison
Cyclooxygenase-2 selective NSAIDs and/or… vs Nonusers, traditional nonselective NSAIDs, or no…
Design
Review
Key result
Nonselective NSAIDs increased the relative risk of hospitalization for upper gastrointestinal bleeding compared with celecoxib (RR 4.4; 95% CI 2.3-8.5) and rofecoxib (RR 1.9; 95% CI 1.0-3.5).
Authors
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GI risk stratification with aspirin/NSAIDs remains imprecise; leaves open need for standardized studies to quantify factors.
Does the use of COX-2 selective NSAIDs or gastroprotective cotherapy reduce the risk of gastrointestinal injury in patients taking NSAIDs or low-dose aspirin?
Relative Risk: 4.4 (95% CI 2.3–8.5)
COX-2 selective inhibitors and gastroprotective cotherapy (proton pump inhibitors or misoprostol) significantly reduce the risk of upper gastrointestinal injury and bleeding in patients requiring NSAIDs, particularly those on concurrent low-dose cardioprotective aspirin.
Dubois et al. (2004) conducted a review in Patients treated with NSAIDs. Nonselective NSAIDs vs. COX-2 selective inhibitors (celecoxib, rofecoxib) was evaluated on Hospitalization resulting from upper gastrointestinal bleeding (RR 4.4, 95% CI 2.3-8.5). Nonselective NSAIDs increased the relative risk of hospitalization for upper gastrointestinal bleeding compared with celecoxib (RR 4.4; 95% CI 2.3-8.5) and rofecoxib (RR 1.9; 95% CI 1.0-3.5).