BACKGROUNDS:Gastrointestinal (GI) toxicity is an undesirable effect of nonsteroidal anti-inflammatory drugs (NSAIDs). We conducted a multicenter study in Japan to clarify the GI risk grade in patients with NSAID-induced GI bleeding.
METHODS:Patients with emergent endoscopic hemostasis by nonvariceal bleeding were registered from 36 hospitals in Hiroshima. In cases with NSAID use, the GI risk grade (low, moderate, or high) was evaluated, and concomitant drugs were investigated. We asked 79 gastroenterologists and 234 orthopedists what concomitant drugs they would prescribe to 3 simulated patients.
RESULTS:A total of 1,350 patients were registered. NSAIDs were used in 278 cases (21%). Concerning the risk grade in each patient, the largest group was the moderate-risk group (203 patients; 73%), while the high-risk group comprised 10% of all NSAID users with bleeding. A proton pump inhibitor (PPI) or misoprostol was administrated to only 20 patients (7%). A small number of the gastroenterologists and orthopedists who responded to the questionnaire would prescribe PPI or misoprostol to simulated patients with short-term loxoprofen use.
CONCLUSIONS:In NSAID users with GI bleeding, the moderate-risk group was the largest group for GI toxicity in Japan. In these cases, PPI or misoprostol was not commonly medicated in clinical practice.
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【Evaluation of individual risk in nonvariceal gastrointestinal bleeding patients with NSAID administration: a multicenter study in Japan.].
【NSAID给药对非静脉曲张性胃肠道出血患者的个体风险评估：日本的一项多中心研究。】
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DOI：10.1159/000339710文章类型：杂志文章
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背景：胃肠道（GI）毒性是非甾体类抗炎药（NSAID）的不良作用。我们在日本进行了一项多中心研究，以阐明NSAID诱发的GI出血患者的GI风险等级。
方法：从广岛市的36家医院登记了因非静脉曲张破裂出血而紧急内镜止血的患者。在使用NSAID的情况下，评估了GI风险等级（低，中或高），并研究了伴随药物。我们询问了79位肠胃科医生和234位骨科医师，他们将给3位模拟患者开哪些伴随药物。
结果：总共登记了1350名患者。 NSAIDs用于278例（21％）。关于每位患者的风险等级，最大的组是中度风险组（203名患者； 73％），而高风险组占所有出血的NSAID使用者的10％。仅对20例患者（7％）施用了质子泵抑制剂（PPI）或米索前列醇。回答问卷的少数肠胃科医生和骨科医生会为短期使用洛索洛芬的模拟患者开具PPI或米索前列醇。
结论：在有胃肠道出血的非甾体抗炎药使用者中，中度风险组是日本最大的胃肠道毒性组。在这些情况下，临床实践中通常不使用PPI或米索前列醇。
方法：从广岛市的36家医院登记了因非静脉曲张破裂出血而紧急内镜止血的患者。在使用NSAID的情况下，评估了GI风险等级（低，中或高），并研究了伴随药物。我们询问了79位肠胃科医生和234位骨科医师，他们将给3位模拟患者开哪些伴随药物。
结果：总共登记了1350名患者。 NSAIDs用于278例（21％）。关于每位患者的风险等级，最大的组是中度风险组（203名患者； 73％），而高风险组占所有出血的NSAID使用者的10％。仅对20例患者（7％）施用了质子泵抑制剂（PPI）或米索前列醇。回答问卷的少数肠胃科医生和骨科医生会为短期使用洛索洛芬的模拟患者开具PPI或米索前列醇。
结论：在有胃肠道出血的非甾体抗炎药使用者中，中度风险组是日本最大的胃肠道毒性组。在这些情况下，临床实践中通常不使用PPI或米索前列醇。
