Featured Research

from universities, journals, and other organizations

Slow-release NSAIDs pose greater risk of GI bleeding, study finds

Date:
May 28, 2010
Source:
Wiley-Blackwell
Summary:
The risk of gastrointestinal complications due to non-steroidal anti-inflammatory drug (NSAID) use varies by specific NSAID administered and by dosage, according to new research. The study further determined that NSAIDs with a long half-life or slow-release formulation are associated with a greater risk of GI bleeding or perforation.

A study conducted at the Spanish Centre for Pharmacoepidemiological Research revealed that the risk of gastrointestinal complications due to nonsteroidal anti-inflammatory drug (NSAID) use varies by specific NSAID administered and by dosage. The study further determined that NSAIDs with a long half-life or slow-release formulation are associated with a greater risk of GI bleeding or perforation. Study findings are published in the June issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.

NSAIDs such as Advil, Motrin and Aleve, are drugs that treat pain and inflammation by blocking the action of two cyclooxygenase (COX) enzymes. COX-2 promotes inflammation, but COX-1 protects the lining of the stomach. If an NSAID inhibits both COX-1 and COX-2, GI bleeding and ulcers can result.

According to the American College of Gastroenterology, it has long been recognized that persons using NSAIDs are at a significantly increased risk of gastrointestinal complications, for instance, injury to the intestinal lining that can result in ulcers and/or gastrointestinal bleeding. With millions taking NSAID pain medications every day, it is estimated that more than 100,000 Americans are hospitalized each year and between 15,000 and 20,000 Americans die each year from ulcers and gastrointestinal bleeding linked to NSAID use.

To reduce the morbidity associated with NSAIDs, specific estimates for individual drugs and individual groups of patients with different risk profiles are needed. This study assessed the risk of upper GI bleeding and perforation among individual NSAIDs and analyzed the correlation between this risk and the degree of inhibition of whole blood COX-1 and COX-2 in vitro.

The research team conducted a systematic review of nine observational studies on NSAIDs and upper GI bleeding/perforation published between 2000 and 2008. The article criteria was 1) report case-control or cohort studies evaluating traditional NSAID or coxib use and upper GI bleeding/perforation in the general population, and 2) provide either an estimate or enough data to estimate a relative risk comparing NSAID users with nonusers. The pooled relative risk (RR) estimates of upper GI bleeding/perforation for individual NSAIDs was calculated, as well as whether the degree of inhibition of whole blood COX-1 and COX-2 in vitro by average circulating concentrations predicted the RR of upper GI bleeding/perforation.

The analysis suggests that NSAID-associated upper GI toxicity is the result of two pharmacologic features: drug exposure and sparing of COX-1 activity. These findings support the notion that there are multifactorial determinants in the risk of upper GI bleeding/perforation among NSAID users, including clinical background, use of concomitant medications, or a possible genetic susceptibility.

Study leader Luis A. García Rodríguez, M.D. states, "We showed that persistent exposure to the drug is an important independent determinant; in fact, drugs with a long half-life or slow-release formulation were associated overall with a greater risk than NSAIDs with a short half-life. We observed the lowest GI toxicity with coxibs, i.e., celecoxib and rofecoxib, which supports the notion that sparing of COX-1 in the GI tract and possibly in platelets translates clinically to a lower upper GI risk."


Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.


Journal Reference:

  1. Elvira L. Massó-González, Paola Patrignani, Stefania Tacconelli, Luis A. García-Rodríguez. Variability of risk of upper gastrointestinal bleeding among nonsteroidal anti-inflammatory drugs. Arthritis & Rheumatism, 2010; DOI: 10.1002/art.27412

Cite This Page:

Wiley-Blackwell. "Slow-release NSAIDs pose greater risk of GI bleeding, study finds." ScienceDaily. ScienceDaily, 28 May 2010. <www.sciencedaily.com/releases/2010/05/100526111326.htm>.
Wiley-Blackwell. (2010, May 28). Slow-release NSAIDs pose greater risk of GI bleeding, study finds. ScienceDaily. Retrieved September 19, 2014 from www.sciencedaily.com/releases/2010/05/100526111326.htm
Wiley-Blackwell. "Slow-release NSAIDs pose greater risk of GI bleeding, study finds." ScienceDaily. www.sciencedaily.com/releases/2010/05/100526111326.htm (accessed September 19, 2014).

Share This



More Health & Medicine News

Friday, September 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) — The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) — A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com
How The 'Angelina Jolie Effect' Increased Cancer Screenings

How The 'Angelina Jolie Effect' Increased Cancer Screenings

Newsy (Sep. 19, 2014) — Angelina's Jolie's decision to undergo a preventative mastectomy in 2013 inspired many women to seek early screenings for the disease. Video provided by Newsy
Powered by NewsLook.com
The Cost of Ebola

The Cost of Ebola

Reuters - Business Video Online (Sep. 18, 2014) — As Sierra Leone prepares for a three-day "lockdown" in its latest bid to stem the spread of Ebola, Ciara Lee looks at the financial implications of fighting the largest ever outbreak of the disease. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins