PMID- 34738287
OWN - NLM
STAT- MEDLINE
DCOM- 20220325
LR  - 20220325
IS  - 1099-1557 (Electronic)
IS  - 1053-8569 (Linking)
VI  - 31
IP  - 3
DP  - 2022 Mar
TI  - Utilization trend of gastric acid-suppressing agents in relation to analgesics.
PG  - 314-321
LID - 10.1002/pds.5381 [doi]
AB  - BACKGROUND: Controversies exist about excessive use of gastric acid-suppressing 
      agents or lack of adequate indications, especially when co-prescribed with 
      analgesics for gastroprotection. We aimed to analyze the nationwide trend of 
      gastric acid-suppressing agents and analgesics. METHODS: We obtained nationwide 
      consumption data of analgesics (nonsteroidal anti-inflammatory drugs [NSAIDs], 
      opioids, others) and gastric acid-suppressing agents (proton pump inhibitors 
      [PPI] and histamine-2 receptor antagonists [H2RAs]) between years of 2014-2018 
      from IQVIA Turkey. Drug utilization was measured by defined daily dose (DDD)/1000 
      inhabitants/day (DID) unit. Drug sales data were further used to test the 
      correlation of PPIs and H2RAs to analgesics. RESULTS: During the study period, 
      analgesic utilization increased from 65.7 to 67.4 DID. NSAIDs constituted 
      82.7%-84.9% of all analgesic utilization. The consumption of NSAIDs increased by 
      3.1%, and the most commonly consumed analgesic was diclofenac (18.5 +/- 1.5 DID), 
      constituting 25.4%-29.0% of all analgesics. PPI utilization was found to 
      regularly raise from 52.1 DID in 2014 to 72.0 DID in 2018 with an overall 
      increment of 38.2%. Use of H2RAs was found to increase from 11.4 DID in 2014 to 
      14.0 DID in 2018. The physician visit-adjusted utilization of both antirheumatic 
      NSAIDs and non-antirheumatic analgesics showed significantly moderate-strong 
      positive correlations with PPIs (r: 0.63, 0.48-0.76 and r: 0.63, 0.47-0.75, 
      respectively) and H2RAs (r: 0.61, 0.44-0.73 and r: 0.57, 0.41-0.71, 
      respectively). CONCLUSION: The utilization trend exhibited a dramatic increase of 
      the gastric acid-suppressing agents -more pronounced for PPIs, with a modest 
      increase in analgesics. Excessive utilization of PPIs does not seem to imply a 
      tendency toward only NSAID-related gastroprotection.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Kirmizi, Neriman Ipek
AU  - Kirmizi NI
AD  - Department of Medical Pharmacology, School of Medicine, Istanbul Medipol 
      University, Istanbul, Turkey.
FAU - Aydin, Volkan
AU  - Aydin V
AD  - Department of Medical Pharmacology, International School of Medicine, Istanbul 
      Medipol University, Istanbul, Turkey.
FAU - Akici, Ahmet
AU  - Akici A
AUID- ORCID: 0000-0002-8593-0818
AD  - Department of Medical Pharmacology, School of Medicine, Marmara University, 
      Istanbul, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20211117
PL  - England
TA  - Pharmacoepidemiol Drug Saf
JT  - Pharmacoepidemiology and drug safety
JID - 9208369
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - *Gastric Acid
MH  - *Gastrointestinal Agents
MH  - Histamine H2 Antagonists/therapeutic use
MH  - Humans
MH  - Proton Pump Inhibitors/therapeutic use
OTO - NOTNLM
OT  - analgesics
OT  - diclofenac
OT  - gastric acid-suppressing agents
OT  - pantoprazole
OT  - ranitidine
OT  - utilization trend
EDAT- 2021/11/06 06:00
MHDA- 2022/03/26 06:00
CRDT- 2021/11/05 07:03
PHST- 2021/10/18 00:00 [revised]
PHST- 2021/02/24 00:00 [received]
PHST- 2021/10/31 00:00 [accepted]
PHST- 2021/11/06 06:00 [pubmed]
PHST- 2022/03/26 06:00 [medline]
PHST- 2021/11/05 07:03 [entrez]
AID - 10.1002/pds.5381 [doi]
PST - ppublish
SO  - Pharmacoepidemiol Drug Saf. 2022 Mar;31(3):314-321. doi: 10.1002/pds.5381. Epub 
      2021 Nov 17.