Review of NSAIDs, Coxibs, and Gastrointestinal Harm
Author Information
Author(s): R Andrew Moore, Sheena Derry, Ceri J Phillips, Henry J McQuay
Primary Institution: University of Oxford
Hypothesis
Do NSAIDs and coxibs differ in their gastrointestinal harm and effectiveness in clinical practice?
Conclusion
Coxibs show strong evidence of reduced gastrointestinal bleeding compared to NSAIDs, but many patients who need gastroprotection do not receive it.
Supporting Evidence
- Evidence of efficacy of coxibs compared to NSAIDs for upper gastrointestinal bleeding was strong.
- Patients receiving coxibs had more gastrointestinal risk factors than those receiving NSAIDs.
- 76% of patients with at least one gastrointestinal risk factor received no prescription for gastroprotective agent with an NSAID.
Takeaway
Some pain medicines can hurt your stomach, but there are safer options. However, many people who need help don't get it.
Methodology
Systematic literature searches and analysis of clinical trials and observational studies.
Potential Biases
Channelling bias in observational studies due to differing risk factors among patients.
Limitations
Limited information on bowel damage and adherence to prescribed gastroprotection.
Participant Demographics
1.6 million patients studied, including 911,000 NSAID users.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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