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Outcome of peptic ulcer bleeding among users of traditional non‐steroidal anti‐inflammatory drugs and selective cyclo‐oxygenase‐2 inhibitors
Author(s) -
THOMSEN R. W.,
RIIS A.,
CHRISTENSEN S.,
MCLAUGHLIN J. K.,
SØRENSEN H. T.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.03139.x
Subject(s) - medicine , celecoxib , rofecoxib , drug , peptic , peptic ulcer , gastroenterology , population , cohort , mortality rate , pharmacology , cyclooxygenase , biochemistry , chemistry , environmental health , enzyme
Summary Background Few data exist on the impact of non‐steroidal anti‐inflammatory drug use on peptic ulcer outcome. Aim To examine the 30‐day mortality from peptic ulcer bleeding associated with the use of traditional non‐steroidal anti‐inflammatory drugs and newer selective cyclo‐oxygenase‐2 inhibitors. Methods Cohort study of patients with a first hospitalization for peptic ulcer bleeding in three Danish counties between 1991 and 2003. Data on pre‐admission non‐steroidal anti‐inflammatory drug use, use of other ulcer‐related drugs and comorbidities were obtained from population‐based registries. Follow‐up data on mortality were obtained from the Danish Civil Registry System. Results Of 7232 patients hospitalized for peptic ulcer bleeding, 28% were current non‐steroidal anti‐inflammatory drug users. Thirty‐day mortality was 11% overall, and 13% among current non‐steroidal anti‐inflammatory drug users. Compared with never‐use, the adjusted 30‐day mortality rate ratios were 1.4 (95% CI: 1.1–1.9) for current use of non‐steroidal anti‐inflammatory drugs alone and 1.3 (95% CI: 1.0–1.7) for current use combined with other ulcer‐related drugs. For users of celecoxib, alone and in combination, adjusted mortality rate ratios were 1.4 (95% CI: 0.5–3.9) and 2.0 (95% CI: 1.2–3.5), and for users of rofecoxib, 1.2 (95% CI: 0.4–3.9) and 0.9 (95% CI: 0.5–1.6). Conclusion Among patients hospitalized with peptic ulcer bleeding, use of non‐steroidal anti‐inflammatory drugs, including some newer cyclo‐oxygenase‐2 inhibitors, is associated with increased short‐term mortality.