[Risk factors and comorbidities for NSAID associated ulcer]

Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to increase the risk of upper gastrointestinal tract bleeding. To reduce the morbidity associated with NSAID, it will be necessary to establish specific estimates individual drugs and different risk profile. Advanced age has been identified as one of the primary risk factors for adverse GI events in NSAID users. This may be due to the increased use of these drugs by the elderly population or to pathophysiological mechanisms such as age-related changes in drug pharmacokinetics or reductions in gastroduodenal defensive mechanisms. Many studies have also identified the following risk factor: sexuality; history of previous GI problems; higher NSAID doses; concomitant anticoagulant use. Corticosteroids, bisphosphonates and selective serotonin reuptake inhibitors increase the risk of upper gastrointestinal bleeding. The combined use of these drug and NSAID strongly increases the risk of gastrointestinal bleeding. Adverse GI events in NSAID users can be affected by the following comorbidities: rheumatoid arthritis; liver cirrhosis; renal failure; diabetes; arteriosclerosis.