|
|||||
|
|
Case-control study on the association of upper gastrointestinal bleeding and nonsteroidal anti-inflammatory drugs in Japan |
|
| Authors: | Choitsu Sakamoto Kentaro Sugano Shinichi Ota Nobuhiro Sakaki Shin’ichi Takahashi Yukio Yoshida Taku Tsukui Hiroyuki Osawa Yukihiro Sakurai Junji Yoshino Yuji Mizokami Tetsuya Mine Tetsuo Arakawa Hajime Kuwayama Katsunori Saigenji Koji Yakabi Tsutomu Chiba Tooru Shimosegawa Jane E. Sheehan Susana Perez-Gutthann Takuhiro Yamaguchi David W. Kaufman Tsugumichi Sato Kiyoshi Kubota Akira Terano |
| Affiliation: | (1) Nippon Medical School, Tokyo, Japan;(2) Jichi Medical School, Tochigi, Japan;(3) Saitama Medical School, Saitama, Japan;(4) Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan;(5) Kyorin University School of Medicine, Tokyo, Japan;(6) Jichi Medical School Omiya Medical Center, Saitama, Japan;(7) Kanto Medical Center NTT EC, Tokyo, Japan;(8) Fujita Health University Banbuntane Hotokukai Hospital, Aichi, Japan;(9) Tokyo Medical University Kasumigaura Hospital, Ibaraki, Japan;(10) Tokai University School of Medicine, Kanagawa, Japan;(11) Osaka City University Medical School, Osaka, Japan;(12) University Hospital at Koshigaya, Dokkyo University School of Medicine, Saitama, Japan;(13) Kitasato University East Hospital, Kanagawa, Japan;(14) Teikyo University School of Medicine Ichihara Hospital, Chiba, Japan;(15) Graduate School of Medicine, Kyoto University, Kyoto, Japan;(16) Graduate School of Medicine, Tohoku University, Miyagi, Japan;(17) Slone Epidemiology Center, Boston University, Boston, MA, USA;(18) Pfizer Worldwide Development, Barcelona, Spain;(19) School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan;(20) Faculty of Medicine, University of Tokyo, Tokyo, Japan;(21) Drug Safety Research Unit Japan, Tokyo, Japan;(22) Dokkyo University School of Medicine, Tochigi, Japan;(23) Department of Pharmacoepidemiology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan |
| Abstract: | Objective Studies in Western populations have shown the association of nonsteroidal anti-inflammatory drugs (NSAIDs) and upper gastrointestinal bleeding (UGIB). The role of Helicobacter pylori infection in NSAIDs-related UGIB remains to be studied. We conducted a case-control study in Japan to investigate these related topics.Methods Cases of UGIB due to duodenal or gastric ulcer, or gastritis were identified in 14 study hospitals in various areas of Japan. For each case, two controls were identified from population registries in the same district. Information on drugs and other risk factors was obtained from 175 cases and 347 controls by telephone interviews. Anti-H. pylori antibody in the urine was measured in a single laboratory for all the cases and 225 controls.Results The odds ratio (OR) of UGIB was 5.5 for aspirin and 6.1 for other NSAIDs (NANSAIDs) (p<0.01). The OR for regular use was higher than for occasional use both for aspirin (7.7 vs 2.0) and NANSAIDs (7.3 vs 4.1). Loxoprofen (5.9), frequently used in Japan as a safe ‘prodrug’, was significantly associated with UGIB. The odds ratio for H. pylori infection was 4.9 and the relative excess risk due to the interaction between H. pylori and the use of NSAID was 1.2 (95% CI: −5.8–8.1).Conclusion NSAIDs including loxoprofen increase the risk of UGIB in Japan as in Western countries, with a similar magnitude of association. There was no evidence of biological interaction between NSAIDs and H. pylori infection. |
| Keywords: | Adverse drug effects Anti-inflammatory agents, non-steroidal Case-control studies Gastrointestinal hemorrhage Japan |
| 本文献已被 PubMed SpringerLink 等数据库收录！ | |