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Risk factors for severe nonsteroidal anti-inflammatory drug-induced small intestinal damage

Toshio Watanabe1, Tetsuya Tanigawa, Yuji Nadatani

  • 1Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan. watanabet@med.osaka-cu.ac.jp

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|January 22, 2013
PubMed
Abstract

Insights

Elderly patients and those using acid suppressants face a higher risk of severe small intestinal damage from nonsteroidal anti-inflammatory drugs (NSAIDs). These findings highlight key risk factors for NSAID-induced enteropathy.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Rheumatology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause small intestinal damage.
  • Risk factors for NSAID-induced enteropathy are not well-established.
  • Rheumatoid arthritis patients frequently use NSAIDs.

Purpose of the Study:

  • To identify risk factors for NSAID-induced enteropathy in rheumatoid arthritis patients.
  • To assess the association between patient characteristics and NSAID-induced small intestinal damage.

Main Methods:

  • A cross-sectional study involving 113 rheumatoid arthritis patients using NSAIDs for over 3 months.
  • Capsule endoscopy was performed to evaluate small intestinal damage.
  • Damage was scored, and risk factors for severe damage were analyzed using multivariate logistic regression.

Main Results:

  • 30 patients (27.8%) experienced severe NSAID-induced enteropathy.
  • Advanced age (≥65 years) was a significant risk factor (OR, 4.16).
  • Use of proton pump inhibitors (OR, 5.22) and histamine H2 receptor antagonists (OR, 3.95) were independent risk factors for severe damage.

Conclusions:

  • Elderly patients are at increased risk for severe NSAID-induced enteropathy.
  • Use of acid-suppressing medications (PPIs and H2 blockers) increases the risk of severe NSAID-induced enteropathy.
  • These findings aid in identifying high-risk patients for NSAID-induced small intestinal damage.

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