Safety risk associated with use of nonsteroidal anti-inflammatory drugs in Japanese elderly compared with younger patients with osteoarthritis and/or chronic low back pain: A retrospective database study

被引:8
作者
Togo, Kanae [1 ]
Ebata, Nozomi [1 ]
Yonemoto, Naohiro [1 ]
Abraham, Lucy [2 ]
机构
[1] Pfizer Japan Inc, Tokyo, Japan
[2] Pfizer Ltd, Surrey, England
关键词
acute myocardial infarction; chronic low back pain; gastrointestinal events; nonsteroidal anti-inflammatory drugs; osteoarthritis; renal events; MANAGEMENT; INHIBITORS; PATTERNS; EVENTS; HEALTH; NSAID;
D O I
10.1111/papr.13079
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose This study aimed to assess the safety risks associated with using nonsteroidal anti-inflammatory drugs (NSAIDs) in elderly patients (>= 65 years) compared with younger patients (<65 years) with osteoarthritis (OA) and/or chronic low back pain (CLBP). Methods A retrospective analysis was conducted on anonymized claims data of patients prescribed NSAIDs for OA and/or CLBP from 2009 to 2018 using hospital-based administrative database-Medical Data Vision (MDV). The key outcome was the incidence of developing gastrointestinal (GI), renal, and acute myocardial infarction (AMI) that are well-known events associated with NSAID use. Results Of 288,715 patients included, 23.7%, 60.5%, and 15.8% had OA, CLBP, or both, respectively. Elderly patients used non-oral NSAIDs more frequently than oral NSAIDs (57.8% and 38.7%, respectively), whereas younger patients showed comparable use (50.7% and 52.8%, respectively). The incidence of events per 10,000 person-years (95% CI) was higher in the elderly than in younger patients: GI, 29.68(27.67-31.68) vs. 16.61(14.60-18.63); renal, 124.77(120.56-128.99) vs. 39.88(36.72-43.03); and AMI, 27.41(25.48-29.35) vs. 10.90(9.27-12.53), respectively. After adjusting for covariates, the increase in risk for these events was seen in patients >70 years compared with younger patients (18-30 years) and was remarkable in patients >80 years with 2-fold, 10-fold, and 7-fold higher risk for developing GI, renal, and AMI events, respectively. Conclusion Risk for developing NSAID-associated events was higher in the elderly; particularly, renal and AMI events that remarkably increased in patients >80 years. To reduce them, NSAIDs should be prescribed at the lowest effective dose for the shortest duration possible.
引用
收藏
页码:200 / 209
页数:10
相关论文
共 44 条
  • [1] Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Usage and co-prescription with other potentially interacting drugs in elderly: A cross-sectional study
    Abdu, Nuru
    Mosazghi, Asmerom
    Teweldemedhin, Samuel
    Asfaha, Luwam
    Teshale, Makda
    Kibreab, Mikal
    Anand, Indermeet Singh
    Tesfamariam, Eyasu H.
    Russom, Mulugeta
    [J]. PLOS ONE, 2020, 15 (10):
  • [2] Guidance on the management of pain in older people
    Abdulla, Aza
    Adams, Nicola
    Bone, Margaret
    Elliott, Alison M.
    Gaffin, Jean
    Jones, Derek
    Knaggs, Roger
    Martin, Denis
    Sampson, Liz
    Schofield, Pat
    [J]. AGE AND AGEING, 2013, 42 : I1 - I57
  • [3] Risk of Gastrointestinal Bleeding Increases With Combinations of Antithrombotic Agents and Patient Age
    Abraham, Neena S.
    Noseworthy, Peter A.
    Inselman, Jonathan
    Herrin, Jeph
    Yao, Xiaoxi
    Sangaralingham, Lindsey R.
    Cornish, Gabriella
    Ngufor, Che
    Shah, Nilay D.
    [J]. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2020, 18 (02) : 337 - +
  • [4] Nephrotoxicity in the elderly due to co-prescription of angiotensin converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs
    Adhiyaman, V
    Asghar, M
    Oke, A
    White, AD
    Shah, IU
    [J]. JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, 2001, 94 (10) : 512 - 514
  • [5] Patterns of drug treatment in patients with osteoarthritis and chronic low back pain in Japan: a retrospective database study
    Akazawa, Manabu
    Mimura, Wataru
    Togo, Kanae
    Ebata, Nozomi
    Harada, Noriko
    Murano, Haruka
    Abraham, Lucy
    Fujii, Koichi
    [J]. JOURNAL OF PAIN RESEARCH, 2019, 12 : 1631 - 1648
  • [6] Nonsteroidal Anti-inflammatory Drugs Utilization Patterns and Risk of Adverse Events due to Drug-Drug Interactions among Elderly Patients: A Study from Jordan
    Al-Azayzih, Ahmad
    Al-Azzam, Sayer, I
    Alzoubi, Karem H.
    Jarab, Anan S.
    Kharaba, Zelal
    Al-Rifai, Rami H.
    Alnajjar, Munther S.
    [J]. SAUDI PHARMACEUTICAL JOURNAL, 2020, 28 (04) : 504 - 508
  • [7] [Anonymous], 2013, BMJ-BRIT MED J, DOI DOI 10.1136/BMJ.E8525
  • [8] Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data
    Bally, Michele
    Dendukuri, Nandini
    Rich, Benjamin
    Nadeau, Lyne
    Helin-Salmivaara, Arja
    Garbe, Edeltraut
    Brophy, James M.
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2017, 357
  • [9] OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis
    Bannuru, R. R.
    Osani, M. C.
    Vaysbrot, E. E.
    Arden, N. K.
    Bennell, K.
    Bierma-Zeinstra, S. M. A.
    Kraus, V. B.
    Lohmander, L. S.
    Abbott, J. H.
    Bhandari, M.
    Blanco, F. J.
    Espinosa, R.
    Haugen, I. K.
    Lin, J.
    Mandl, L. A.
    Moilanen, E.
    Nakamura, N.
    Snyder-Mackler, L.
    Trojian, T.
    Underwood, M.
    McAlindon, T. E.
    [J]. OSTEOARTHRITIS AND CARTILAGE, 2019, 27 (11) : 1578 - 1589
  • [10] Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials
    Bhala, N.
    Emberson, J.
    Merhi, A.
    Abramson, S.
    Arber, N.
    Baron, J. A.
    Bombardier, C.
    Cannon, C.
    Farkouh, M. E.
    FitzGerald, G. A.
    Goss, P.
    Halls, H.
    Hawk, E.
    Hawkey, C.
    Hennekens, C.
    Hochberg, M.
    Holland, L. E.
    Kearney, P. M.
    Laine, L.
    Lanas, A.
    Lance, P.
    Laupacis, A.
    Oates, J.
    Patrono, C.
    Schnitzer, T. J.
    Solomon, S.
    Tugwell, P.
    Wilson, K.
    Wittes, J.
    Baigent, C.
    Adelowo, O.
    Aisen, P.
    Al-Quorain, A.
    Altman, R.
    Bakris, G.
    Baumgartner, H.
    Bresee, C.
    Carducci, M.
    Chang, D-M.
    Chou, C-T.
    Clegg, D.
    Cudkowicz, M.
    Doody, L.
    El Miedany, Y.
    Falandry, C.
    Farley, J.
    Ford, L.
    GarciLosa, M.
    Gonzalez-Ortiz, M.
    Haghighi, M.
    [J]. LANCET, 2013, 382 (9894) : 769 - 779