Observational survey of NSAID-related upper gastro-intestinal adverse events in Belgium
| Journal | Volume 65 - 2002 |
| Issue | Fasc.2 - Original articles |
| Author(s) | J. Belaiche, A. Burette, M. De Vos, E. Louis, M. Huybrechts, M. Deltenre |
| Full article |
 VIEW FREE PDF |
| On behalf of the Belgian Study Group of NSAID-GI complications. (1) Department of Gastroenterology, CHU Sart-Tilman, Liège, Belgium ; (2) Gastroenterology Dept. Clinic Edith Cavell, nouvelle Clinique de la Basilique, Brussels, Belgium ; (3) Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium ; (4) AstraZeneca pharmaceuticals, Brussels, Belgium ; (5) Gastroenterology Dept. CHU Brugmann, ULB/VUB, Brussels, Belgium. |
|
Objectives : To evaluate the impact of NSAID use on current routine upper GI endoscopy (UGIE) and to compare the lesions found in NSAID users and non-users. Methods : Participating gastroenterologists consecutively docu- mented outpatients with and without suspicion of bleeding, referred for upper gastrointestinal endoscopy. Patient characteris- tics, presence of risk factors, NSAID use and endoscopic findings were reported on standard data collection forms. Main results : A total of 2685 non-bleeding and 159 bleeding patients were enrolled within a time period of 2 months. NSAID therapy was present in 20% of the non-bleeding patients and at least 9% of referrals for endoscopy were directly related to sus- pected NSAID adverse events. Nearly half of acute bleeding patients (42%) were NSAID users, including aspirin for cardio- prevention. Warning digestive symptoms prior to acute bleeding were frequently absent (56%). oesophagitis was the main endo- scopic diagnosis (51% of patients). Gastroduodenal (GD) ulcer was significantly more frequent in NSAID users, whereas oesophagitis and bleeding oesophageal varices were more frequent among non-users. Analysis of odds ratio's demonstrated NSAID use to significantly increase the risk for gastric ulcer in the whole patient group (OR = 2.73 ; 95% confidence interval (CI) : 1.98- 3.77 ; p < 0.001) and, in addition, for duodenal ulcer in the elderly (>65y) subgroup (OR = 2.91 ; 95% CI : 1.52-5.59 ; p < 0.05). Conclusions : This survey confirms the high incidence of GD ulcers in NSAID users and the risk for serious gastrointestinal complications, often occurring without warning symptoms. It underlines the impact of NSAID use on the routine endoscopy load, the necessity of careful selection of patients for NSAID pre- scriptions and the need for gastropreventive measures, particular- ly in elderly patients and patients associating multiple risk factors. (Acta gastroenterol. belg., 2002, 65, 65-73). |
|
© Acta Gastro-Enterologica Belgica. |
