PMID- 17323403
OWN - NLM
STAT- MEDLINE
DCOM- 20071023
LR  - 20131121
IS  - 1053-8569 (Print)
IS  - 1053-8569 (Linking)
VI  - 16
IP  - 8
DP  - 2007 Aug
TI  - Comparison of the effects of diclofenac or other non-steroidal anti-inflammatory 
      drugs (NSAIDs) and diclofenac or other NSAIDs in combination with proton pump 
      inhibitors (PPI) on hospitalisation due to peptic ulcer disease.
PG  - 854-8
AB  - PURPOSE: Up to 25% of patients taking non-steroidal anti-inflammatory drugs 
      (NSAIDs) chronically experience gastrointestinal side effects. This report aims 
      to determine the gastroprotective effects of proton pump inhibitors (PPI) in 
      patients taking NSAIDs, especially diclofenac. METHODS: From the claims database 
      of a German sickness fund with 1.4 million beneficiaries, we used data from 
      patients enrolled in the health plan continuously from 2000 until 2004 with an 
      inpatient diagnosis of peptic ulcer disease in 2003 and 2004. For our nested 
      case-control study, we matched these cases for calendar time with up to 10 
      controls per case. Our main outcome measure were the adjusted odds ratios (ORs) 
      for peptic ulcer disease associated with diclofenac and other NSAIDs. RESULTS: In 
      the study population of 752 613 beneficiaries, 979 cases and 10 319 controls were 
      identified. A stratified analysis according to the prescription of diclofenac 
      alone or in combination with PPI showed that diclofenac prescriptions increased 
      the risk for hospitalisation due to peptic ulcer significantly (adjusted OR 2.4 
      [95%CI 1.94, 3.05]). If PPI were prescribed concomitantly with diclofenac, we 
      observed a risk reduction (OR 1.3 [95%CI 0.7, 2.3]). The significance of the PPI 
      effect was shown using an interaction term in a regression model without 
      stratification, where a risk reduction of 60% (OR 0.4 [95%CI 0.2, 0.7], p < 0.05) 
      was found. CONCLUSIONS: The concomitant prescription of PPI and diclofenac 
      decreases the hospitalisation risk due to peptic ulcer significantly. The results 
      support the use of PPI as gastroprotective agents in patients who receive NSAIDs.
FAU - Hoer, Ariane
AU  - Hoer A
AD  - IGES, Institute for Healthcare and Social Research, Wichmannstrasse, Berlin, 
      Germany. Ho@iges.de
FAU - Gothe, Holger
AU  - Gothe H
FAU - Schiffhorst, Guido
AU  - Schiffhorst G
FAU - Sterzel, Astrid
AU  - Sterzel A
FAU - Grass, Ulrich
AU  - Grass U
FAU - Haussler, Bertram
AU  - Haussler B
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Pharmacoepidemiol Drug Saf
JT  - Pharmacoepidemiology and drug safety
JID - 9208369
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 144O8QL0L1 (Diclofenac)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Case-Control Studies
MH  - Databases, Factual
MH  - Diclofenac/*adverse effects
MH  - Female
MH  - Germany
MH  - Hospitalization
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Peptic Ulcer/*chemically induced/prevention & control
MH  - *Proton Pump Inhibitors
MH  - Retrospective Studies
MH  - Risk
EDAT- 2007/02/27 09:00
MHDA- 2007/10/24 09:00
CRDT- 2007/02/27 09:00
PHST- 2007/02/27 09:00 [pubmed]
PHST- 2007/10/24 09:00 [medline]
PHST- 2007/02/27 09:00 [entrez]
AID - 10.1002/pds.1387 [doi]
PST - ppublish
SO  - Pharmacoepidemiol Drug Saf. 2007 Aug;16(8):854-8. doi: 10.1002/pds.1387.