Outcome of peptic ulcer bleeding among users of traditional non-steroidal anti-inflammatory drugs and selective cyclo-oxygenase-2 inhibitors
Article first published online: 10 OCT 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 10, pages 1431–1438, November 2006
How to Cite
THOMSEN, R. W., RIIS, A., CHRISTENSEN, S., MCLAUGHLIN, J. K. and SØRENSEN, H. T. (2006), Outcome of peptic ulcer bleeding among users of traditional non-steroidal anti-inflammatory drugs and selective cyclo-oxygenase-2 inhibitors. Alimentary Pharmacology & Therapeutics, 24: 1431–1438. doi: 10.1111/j.1365-2036.2006.03139.x
- Issue published online: 10 OCT 2006
- Article first published online: 10 OCT 2006
- Publication data Submitted 3 May 2006 First decision 20 May 2006 Resubmitted 20 August 2006 Accepted 22 August 2006
Few data exist on the impact of non-steroidal anti-inflammatory drug use on peptic ulcer outcome.
To examine the 30-day mortality from peptic ulcer bleeding associated with the use of traditional non-steroidal anti-inflammatory drugs and newer selective cyclo-oxygenase-2 inhibitors.
Cohort study of patients with a first hospitalization for peptic ulcer bleeding in three Danish counties between 1991 and 2003. Data on pre-admission non-steroidal anti-inflammatory drug use, use of other ulcer-related drugs and comorbidities were obtained from population-based registries. Follow-up data on mortality were obtained from the Danish Civil Registry System.
Of 7232 patients hospitalized for peptic ulcer bleeding, 28% were current non-steroidal anti-inflammatory drug users. Thirty-day mortality was 11% overall, and 13% among current non-steroidal anti-inflammatory drug users. Compared with never-use, the adjusted 30-day mortality rate ratios were 1.4 (95% CI: 1.1–1.9) for current use of non-steroidal anti-inflammatory drugs alone and 1.3 (95% CI: 1.0–1.7) for current use combined with other ulcer-related drugs. For users of celecoxib, alone and in combination, adjusted mortality rate ratios were 1.4 (95% CI: 0.5–3.9) and 2.0 (95% CI: 1.2–3.5), and for users of rofecoxib, 1.2 (95% CI: 0.4–3.9) and 0.9 (95% CI: 0.5–1.6).
Among patients hospitalized with peptic ulcer bleeding, use of non-steroidal anti-inflammatory drugs, including some newer cyclo-oxygenase-2 inhibitors, is associated with increased short-term mortality.