Derivation and Validation of a Major Toxicity Risk Score Among Nonsteroidal Antiinflammatory Drug Users Based on Data From a Randomized Controlled Trial

Arthritis & Rheumatology
D H SolomonNina Paynter

Abstract

While nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used in rheumatology, they can cause major toxicity. Improving the risk/benefit ratio requires a more precise understanding of risk. This study was undertaken to derive and validate a risk score for major toxicity among NSAID users enrolled in a randomized controlled trial. Patients enrolled in a randomized controlled trial who had known cardiovascular disease or risk factors as well as osteoarthritis or rheumatoid arthritis were divided into derivation and validation cohorts. Patients were randomized to receive celecoxib, naproxen, or ibuprofen at typical dosages. The risk score was designed to predict the 1-year occurrence of major toxicity among NSAID users, including major adverse cardiovascular events, acute kidney injury, significant gastrointestinal events, and mortality. Variables significantly associated with major toxicity were candidates for inclusion in the final regression model. After derived models were found to have a similar model fit in the validation set, the cohorts were combined, allowing calculation of a risk score. In the derivation cohort, significant variables included age, male sex, history of cardiovascular disease, hypertension, diabetes...Continue Reading

References

Sep 1, 1991·The American Journal of Medicine·J F FriesB A Michel
Jun 17, 1999·The New England Journal of Medicine·M M WolfeG Singh
May 2, 2000·American Journal of Preventive Medicine·R CrosbyR Brackbill
Jun 29, 2004·The American Journal of Cardiology·Donald M Lloyd-JonesDaniel Levy
Nov 6, 2007·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Ian GrahamUNKNOWN European Atherosclerosis Society (EAS)
Feb 23, 2008·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·J A KanisE McCloskey
Oct 1, 1998·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·J F Fries
Jun 9, 2009·BMC Gastroenterology·Sebastian StraubeHenry J McQuay
Dec 14, 2016·The New England Journal of Medicine·Steven E NissenUNKNOWN PRECISION Trial Investigators

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Cardiovascular Disorder in Diabetes

Diabetes is associated with an increased risk of cardiovascular disorders and heart failure. Discover the latest research here.