Evaluation of individual risk in nonvariceal gastrointestinal bleeding patients with NSAID administration: a multicenter study in japan
Okanobu H et al. – 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.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.
- Authros asked 79 gastroenterologists and 234 orthopedists what concomitant drugs they would prescribe to 3 simulated patients.
- 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.