PMID- 23604350
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130423
LR  - 20220330
IS  - 2044-6055 (Print)
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 3
IP  - 4
DP  - 2013
TI  - Consumption of analgesics before a marathon and the incidence of cardiovascular, 
      gastrointestinal and renal problems: a cohort study.
LID - 10.1136/bmjopen-2012-002090 [doi]
LID - e002090
AB  - OBJECTIVES: To prevent pain inhibiting their performance, many athletes ingest 
      over-the-counter (OTC) analgesics before competing. We aimed at defining the use 
      of analgesics and the relation between OTC analgesic use/dose and adverse events 
      (AEs) during and after the race, a relation that has not been investigated to 
      date. DESIGN: Prospective (non-interventional) cohort study, using an online 
      questionnaire. SETTING: The Bonn marathon 2010. PARTICIPANTS: 3913 of 7048 
      participants in the Bonn marathon 2010 returned their questionnaires. PRIMARY AND 
      SECONDARY OUTCOMES: Intensity of analgesic consumption before sports; incidence 
      of AEs in the cohort of analgesic users as compared to non-users. RESULTS: There 
      was no significant difference between the premature race withdrawal rate in the 
      analgesics cohort and the cohort who did not take analgesics ('controls'). 
      However, race withdrawal because of gastrointestinal AEs was significantly more 
      frequent in the analgesics cohort than in the control. Conversely, withdrawal 
      because of muscle cramps was rare, but it was significantly more frequent in 
      controls. The analgesics cohort had an almost 5 times higher incidence of AEs 
      (overall risk difference of 13%). This incidence increased significantly with 
      increasing analgesic dose. Nine respondents reported temporary hospital 
      admittance: three for temporary kidney failure (post-ibuprofen ingestion), four 
      with bleeds (post-aspirin ingestion) and two cardiac infarctions (post-aspirin 
      ingestion). None of the control reported hospital admittance. CONCLUSIONS: The 
      use of analgesics before participating in endurance sports may cause many 
      potentially serious, unwanted AEs that increase with increasing analgesic dose. 
      Analgesic use before endurance sports appears to pose an unrecognised medical 
      problem as yet. If verifiable in other endurance sports, it requires the 
      attention of physicians and regulatory authorities.
FAU - Kuster, Michael
AU  - Kuster M
AD  - Pain Management Center DGS, Bonn, Bad-Godesberg, Germany.
FAU - Renner, Bertold
AU  - Renner B
FAU - Oppel, Pascal
AU  - Oppel P
FAU - Niederweis, Ursula
AU  - Niederweis U
FAU - Brune, Kay
AU  - Brune K
LA  - eng
PT  - Journal Article
DEP - 20130419
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
PMC - PMC3641448
EDAT- 2013/04/23 06:00
MHDA- 2013/04/23 06:01
PMCR- 2013/04/19
CRDT- 2013/04/23 06:00
PHST- 2013/04/23 06:00 [entrez]
PHST- 2013/04/23 06:00 [pubmed]
PHST- 2013/04/23 06:01 [medline]
PHST- 2013/04/19 00:00 [pmc-release]
AID - bmjopen-2012-002090 [pii]
AID - 10.1136/bmjopen-2012-002090 [doi]
PST - epublish
SO  - BMJ Open. 2013 Apr 19;3(4):e002090. doi: 10.1136/bmjopen-2012-002090. Print 2013.