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Predictive Factors for NSAIDs-related Gastrointestinal Toxicity: Can COX-2 Selective Inhibtor Prevent it?
Background/Aims:
To identify predictive factors for NSAIDs-related GI toxicity and to clarify whether cox-2 selective inhibitors can prevent it or not.
Methodology:
We have surveyed all patients received esophagogastroduodenoscopy examined at our hospital between January 2008 and September 2011. We performed the following retrospective analyses of the clinical records of the 253 patients prescribed NSAIDs. The severity of gastro duodenal mucosal lesions was evaluated using the modified gastro duodenal LANZA score. The following scores for response were used: 0 = no lesions (LANZA score 0); 1 = erosion and redness (LANZA score 1-3); 2 = ulcer (LANZA score 4). Predictors evaluated were factors potentially related to pathogenesis of NSAIDs related GI toxicity. Ordered logistic regression analysis was performed to identify predictive factors for NSAIDs related. ulcer.
Results:
A multivariate logistic regression identified number of risk factors (odds ratio (OR) = 6.82, confidence interval (CI) = 5.31-8.76; P = 0.01), concomitant use of anti- cancer drugs (OR = 2.17, Cl = 1.02-4.62; P = 0.04) were found to be significant factors.
Conclusions:
Number of risk factors and concomitant use of anticancer drugs were shown to be predictive factors for NSAID-related GI toxicity. Use of celecoxib or proton pump inhibitor was not identified as a protective factor.
Insights
Multiple risk factors and concurrent use of anti-cancer drugs predict NSAIDs-related GI toxicity. Celecoxib or proton pump inhibitors did not show protective effects in this study.
Area of Science:
- Gastroenterology
- Pharmacology
- Clinical Medicine
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used but associated with gastrointestinal (GI) toxicity.
- Identifying predictive factors for NSAID-related GI toxicity is crucial for patient safety.
- The protective role of COX-2 selective inhibitors against NSAID-induced GI damage remains a subject of investigation.
Purpose of the Study:
- To identify key predictive factors for NSAID-related gastrointestinal toxicity.
- To evaluate the potential preventive effect of COX-2 selective inhibitors on NSAID-induced GI damage.
Main Methods:
- Retrospective analysis of clinical records from 253 patients prescribed NSAIDs between January 2008 and September 2011.
- Gastro duodenal mucosal lesion severity assessed using the modified gastro duodenal LANZA score.
- Ordered logistic regression analysis employed to identify significant predictive factors for NSAID-related ulcers.
Main Results:
- Multivariate logistic regression identified a higher number of risk factors (OR=6.82) and concomitant use of anti-cancer drugs (OR=2.17) as significant predictors of NSAID-related GI toxicity.
- P-values for these factors were P=0.01 and P=0.04, respectively.
Conclusions:
- The number of risk factors and concurrent use of anti-cancer drugs are significant predictive factors for NSAID-related GI toxicity.
- Neither celecoxib nor proton pump inhibitors were found to be protective against NSAID-induced GI toxicity in this patient cohort.
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