Nonsteroidal anti-inflammatory drug use and increased risk for peptic ulcer disease in elderly persons.
OBJECTIVE
To evaluate the relative risk for peptic ulcer disease that is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs.


METHODS
Nested case-control study.


METHODS
Tennessee Medicaid program.


METHODS
Medicaid enrollees 65 years of age or older were included in the study. The 1415 case patients had been hospitalized for confirmed peptic ulcer disease at some point from 1984 through 1986. The 7063 control persons represented a stratified random sample of other Medicaid enrollees.


RESULTS
The estimated relative risk for the development of peptic ulcer disease among current users of nonaspirin nonsteroidal anti-inflammatory drugs, compared with that among nonusers, was 4.1 (95% CI, 3.5 to 4.7). For current users, the risk increased with increasing dose, from a relative risk of 2.8 (CI, 1.8 to 4.3) for the lowest to a relative risk of 8.0 (CI, 4.4 to 14.8) for the highest dose category. The risk was greatest in the first month of use (relative risk, 7.2; CI, 4.9 to 10.5). If the association is fully causal, 29% of peptic ulcers in the study sample resulted from the use of these drugs, and the excess risk associated with such use was 17.4 hospitalizations for ulcer disease per 1000 person-years of exposure.


CONCLUSIONS
These data support other findings indicating that a clinically significant risk for serious ulcer disease is associated with the use of nonaspirin nonsteroidal anti-inflammatory drugs. The data show that this risk increases with dose and recency of use and that use of these drugs may be responsible for a large proportion of peptic ulcer disease among elderly persons.
Griffin
M R
MR
Vanderbilt University School of Medicine, Nashville, Tennessee.
Piper
J M
JM
Daugherty
J R
JR
Snowden
M
M
Ray
W A
WA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000139:chemically induced*; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin