Risk of gastrointestinal bleeding with concomitant NOAC and glucocorticoid treatment

Area of Science:

• Cardiology
• Gastroenterology
• Pharmacology

Background:

• Non-vitamin K oral anticoagulants (NOACs) are widely used for thromboembolic prevention.
• Oral glucocorticoids are frequently prescribed for various inflammatory conditions.
• The combined use of these medications raises concerns regarding gastrointestinal safety.

Purpose of the Study:

• To investigate the association between concomitant use of oral glucocorticoids and non-vitamin K oral anticoagulants.
• To quantify the risk of gastrointestinal bleeding in patients receiving both medication classes.

Main Methods:

• Retrospective cohort study design.
• Utilized a large healthcare database to identify patients on NOACs.
• Assessed gastrointestinal bleeding events in patients with and without concurrent oral glucocorticoid use.

Main Results:

• Concomitant use of oral glucocorticoids was associated with a significantly increased risk of gastrointestinal bleeding.
• The magnitude of the increased risk was clinically relevant.
• Specific subgroups may be at higher risk.

Conclusions:

• Clinicians should exercise caution when prescribing oral glucocorticoids to patients on non-vitamin K oral anticoagulants.
• Risk stratification and monitoring are recommended to mitigate gastrointestinal bleeding risk.
• Further research may explore alternative strategies for patients requiring both medication classes.