Meta‐analysis of dyspepsia and nonsteroidal antiinflammatory drugs

Abstract

Objective. Nonsteroidal antiinflammatory drug (NSAID) use is a known risk factor for gastrointestinal (GI) perforations, ulcers, and bleeds, but there are limited data on its association with the very common symptom of dyspepsia. Using published and unpublished data sources, we sought to determine estimates of the risks of dyspepsia associated with NSAIDs. Methods. We searched computerized databases (1966 -1998) for primary studies of NSAIDs reporting on GI complications. We also obtained Food and Drug Administration (FDA) new drug application reviews for the 5 most common NSAIDs. We included studies reporting defined upper GI outcomes among subjects (>17 years old) who used oral NSAIDs for more than 4 days. Two reviewers evaluated 4,881 published titles, identifying 55 NSAID versus placebo randomized controlled trials (RCTs), 37 unpublished (FDA data) placebo-controlled RCTs; 86 NSAID versus NSAID RCTs (sample size >50); and 103 observational studies.

Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteoarthritis and rheumatoid arthritis: a systematic review and economic evaluation

“…4 Dyspeptic symptoms occur in 4.8% of NSAIDtreated patients compared with 2.3% on placebo, in randomised trials (which are likely to include healthier subjects) and are the most common reason for cessation of therapy. 31 Dyspeptic symptoms are especially common with indomethacin and piroxicam and with higher doses of NSAIDs, but seem to be equally common with COX-2 selective and non-selective drugs, with prolonged use, 32 and are a poor predictor of peptic ulcers. Half of those investigated for dyspepsia have a normal endoscopy, 15% gastro-oesophageal reflux disease (GORD), 25% peptic ulcers and 2% malignancies.…”

Anti-inflamatórios não esteroides: Efeitos cardiovasculares, cérebro-vasculares e renais

“…These prostaglandins act as cytoprotective agents of the gastrointestinal mucosa; they inhibit the acid secretion by the stomach, increase the local blood flow and the secretion of the protective mucus. Patients with gastroduodenitis, ulcer and mainly digestive bleeding must take proton-pump inhibitors (omeprazole, pantoprazole, lansoprazole etc) daily and the NSAIDs must be taken after the meals 40 .…”

Self-reported symptoms of uninvestigated dypepsia among University staff in Ilorin, Nigeria

“…Dyspepsia is a syndrome which is characterized by the presence of frequently occurring epigastric pain or discomfort that originates from the upper GI tract (3, 4) occurring alone or frequently accompanied by other upper GI symptoms such as heart burn, postprandial fullness, and early satiety (3) belching, vomiting, nausea, postprandial fullness, and early satiety (5,6).…”