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Upper gastrointestinal adverse events and cyclical etidronate
T van Staa1, L Abenhaim, C Cooper
1Procter & Gamble Pharmaceuticals, Staines, United Kingdom.
The American Journal of Medicine
|January 16, 1998
Summary
Cyclical etidronate shows good upper gastrointestinal safety in routine use. This bisphosphonate did not increase the risk of upper GI events, even with concurrent NSAID use.
Area of Science:
- Gastroenterology
- Pharmacology
- Clinical Medicine
Background:
- Aminobisphosphonates have been linked to esophagitis in case reports.
- Evaluating the upper gastrointestinal (GI) safety of bisphosphonates is crucial for patient care.
Purpose of the Study:
- To assess the upper GI safety of cyclical etidronate in real-world clinical settings.
- To compare the incidence of upper GI events in etidronate users versus matched controls.
Main Methods:
- Retrospective analysis of data from 550 UK general practices.
- Inclusion of 7977 cyclical etidronate users and two control groups (osteoporosis and non-osteoporosis).
- Analysis of upper GI events including esophagitis, esophageal ulcers, and stomach/duodenal issues.
Main Results:
- The risk of upper GI events was comparable between etidronate users and control groups.
- Adjusted relative risk for upper GI events was 0.92 (vs. osteoporosis controls) and 1.12 (vs. non-osteoporosis controls).
- No increased incidence of upper GI events observed with concomitant use of etidronate and NSAIDs, aspirin, or corticosteroids.
Conclusions:
- Cyclical etidronate demonstrates a favorable GI tolerability and safety profile in clinical practice.
- Concurrent use of etidronate with NSAIDs, aspirin, or corticosteroids does not elevate upper GI event risk.