PMID- 19250138
OWN - NLM
STAT- MEDLINE
DCOM- 20090611
LR  - 20131121
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 34
IP  - 2
DP  - 2009 Apr
TI  - Gastrointestinal tolerability of aspirin and the choice of over-the-counter 
      analgesia for short-lasting acute pain.
PG  - 177-86
LID - 10.1111/j.1365-2710.2008.00989.x [doi]
AB  - RATIONALE: For the management of common disorders producing short-lasting pain, 
      there is very good evidence of the efficacy of aspirin. Yet paracetamol is often 
      preferred, despite that evidence of its efficacy is much less sound. The reason 
      for this appears to be a concern over gastrointestinal (GI) toxicity. If this 
      concern is misplaced, so may be the preference for paracetamol, with the 
      consequence of widespread sub-optimal treatment. Our purpose in this analysis of 
      pooled individual patient data from clinical studies of aspirin is to adduce the 
      evidence that will show whether or not this is so, for the benefit of consumers 
      and health-care professionals who advise them. METHODS: The frequencies of all 
      and GI adverse events (AEs) and adverse drug reactions (ADRs) were calculated 
      from the pooled individual patient data of nine similar randomized, double-blind, 
      placebo controlled clinical trials of single-doses of aspirin 1000 mg in the 
      treatment of acute migraine attacks, episodic tension-type headache and dental 
      pain. Absolute differences between active and placebo AE and ADR rates, and 
      numbers-needed-to-harm (NNH), were calculated. RESULTS: Of 2852 patients included 
      in the analysis, 1581 were treated with aspirin and 1271 with placebo. Reported 
      AE rates were 14.9% and 11.1% amongst patients allocated to aspirin and placebo 
      respectively (NNH: 26), with the GI system most frequently affected (aspirin: 
      5.9%; placebo: 3.5%; NNH: 42). Reported ADR rates were much lower (aspirin: 6.3%; 
      placebo: 3.9%; NNH: 42), especially for the GI system (aspirin: 3.1%; placebo: 
      2.0%; NNH: 91). Most of the AEs and ADRs were mild or moderate, and none was 
      serious. CONCLUSIONS: The GI ADR differences between aspirin and placebo are not 
      great enough to support decision choices for short-lasting acute pain based on 
      tolerability: these are better based on efficacy.
FAU - Steiner, T J
AU  - Steiner TJ
AD  - Division of Neuroscience and Mental Health, Imperial College London, London, UK. 
      t.steiner@imperial.ac.uk
FAU - Voelker, M
AU  - Voelker M
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Nonprescription Drugs)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
CIN - J Clin Pharm Ther. 2009 Jun;34(3):247-8. PMID: 19646072
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects/*therapeutic use
MH  - Aspirin/*adverse effects/*therapeutic use
MH  - Cross-Over Studies
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Female
MH  - Gastrointestinal Diseases/*chemically induced/epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Nonprescription Drugs
MH  - Pain/*drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Young Adult
RF  - 28
EDAT- 2009/03/03 09:00
MHDA- 2009/06/12 09:00
CRDT- 2009/03/03 09:00
PHST- 2009/03/03 09:00 [entrez]
PHST- 2009/03/03 09:00 [pubmed]
PHST- 2009/06/12 09:00 [medline]
AID - JCP989 [pii]
AID - 10.1111/j.1365-2710.2008.00989.x [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2009 Apr;34(2):177-86. doi: 10.1111/j.1365-2710.2008.00989.x.