Hospitalization for peptic ulcer and bleeding in users of selective COX-2 inhibitors and nonselective NSAIDs with special reference to celecoxib

Pharmacoepidemiology and Drug Safety
M Kay PattersonAlexander M Walker

Abstract

To assess the relative incidence of peptic ulcer bleeding and perforation (PUBP) in users of selective cyclooxygenase-2 (COX-2) inhibitors and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). This was a retrospective case-control study based on insurance claims, with chart review to confirm cases. The base population consisted of 2.2 million adult users of celecoxib, diclofenac, ibuprofen, naproxen, rofecoxib, or valdecoxib who were covered by commercial health insurance in the United States from 1999-2003. For 790 persons hospitalized for PUBP and 7887 controls, most recent NSAID/COX-2 use and a variety of medical and pharmacy risk factors were ascertained from the insurance files and analyzed by conditional logistic regression. The main outcome measure was the odds ratio (OR) associated with use of each drug by comparison to naproxen, and in successive intervals after last dispensing. Hospitalization for PUBP was highest from the date of NSAID/COX-2 dispensing through the end of an exposure period that corresponded to the days supply; the rate dropped steadily thereafter. The covariate-adjusted ORs by comparison to naproxen were: ibuprofen 0.86 (95% confidence interval (CI) 0.68, 1.09), rofecoxib 0.79 (0.62, 1.02),...Continue Reading

References

Jun 17, 1999·The New England Journal of Medicine·M M WolfeG Singh
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Feb 17, 2005·The New England Journal of Medicine·Scott D SolomonUNKNOWN Adenoma Prevention with Celecoxib (APC) Study Investigators
Feb 24, 2006·The American Journal of Medicine·Gurkirpal SinghUNKNOWN SUCCESS-I Investigators
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Sep 18, 2007·Pharmacoepidemiology and Drug Safety·UNKNOWN ISPE

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Citations

Mar 12, 2011·International Journal of Clinical Pharmacy·Elsa López-Pintor, Blanca Lumbreras
Nov 10, 2012·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Jordi CastellsagueUNKNOWN Safety of Non-Steroidal Anti-Inflammatory Drugs (SOS) Project
Jan 14, 2016·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Melissa J McGettiganAmy K Hara
Aug 21, 2013·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·N L de GrootM G H van Oijen

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