A case–control study of the risk of upper gastrointestinal mucosal injuries in patients prescribed concurrent NSAIDs and antithrombotic drugs based on data from the Japanese national claims database of 13 million accumulated patients

Background We aimed to identify the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and antithrombotics on the upper gastrointestinal (GI) mucosa in a clinical setting as a case–control study using a large-scale medical database in Japan. Methods We evaluated the risk of upper GI mu...

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Bibliographic Details
Published in:Journal of gastroenterology 2018-12, Vol.53 (12), p.1253-1260
Main Authors: Sugisaki, Nobuyuki, Iwakiri, Ryuichi, Tsuruoka, Nanae, Sakata, Yasuhisa, Shimoda, Ryo, Fujimoto, Shun, Eguchi, Yuichiro, Fujimoto, Kazuma
Format: Article
Language:English
Subjects:
Abdominal Surgery
Anticoagulants
Antidepressants
Antiplatelet therapy
Aspirin
Bleeding
Colorectal Surgery
Cyclooxygenase-2
Diabetes mellitus
Gastroenterology
Gastroesophageal reflux
Health risk assessment
Hepatology
Hyperlipidemia
Inflammation
Injuries
Medicine
Medicine & Public Health
Mucosa
Nonsteroidal anti-inflammatory drugs
Original Article—Alimentary Tract
Peptic ulcers
Statistical analysis
Surgical Oncology
Ulcers
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Summary:Background We aimed to identify the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and antithrombotics on the upper gastrointestinal (GI) mucosa in a clinical setting as a case–control study using a large-scale medical database in Japan. Methods We evaluated the risk of upper GI mucosal injuries in patients receiving NSAIDs and antithrombotics using the Japan Medical Data Center claims database with data for 13 million accumulated patients, from January 2009 to December 2014. Endoscopically evaluated upper GI mucosal injuries were peptic ulcers ( n  = 143,271), upper GI bleeding ( n  = 10,545), and gastroesophageal reflux disease ( n  = 154,755). For each patient, ten controls were matched by age, sex, and diagnosis month. Results The odds ratio (OR) for peptic ulcers was 1.45, 1.31, 1.50, 1.53, and 1.62; for upper GI bleeding: 1.76, 1.62, 1.96, 1.82, and 2.38; and for gastroesophageal reflux disease: 1.54, 1.41, 1.89, 1.67, and 1.91 for NSAIDs, COX-2 selective inhibitors, low-dose aspirin, antiplatelet drugs, and anticoagulants, respectively (all statistically significant: P  
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-018-1483-x