Terapevticheskii arkhiv · 2018
Do glucocorticoids affect the development of ulcers and erosions of the upper gastrointestinal tract in patients taking NSAIDs.
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Karateev A E, Moroz E V
Аннотация
AIM: To assess the frequency of ulceration and erosion in patients with rheumatic diseases (RD) receiving NSAIDs, depending on the concomitant use of GC.
MATERIALS AND METHODS: A retrospective comparison was made of the incidence of gastrointestinal lesions detected in patients with RD during endoscopic examination in one medical center for 2007-2016. Three groups were formed: in group 1 patients took only NSAIDs (n=4823, women 80.7%, age 51.1 + 15.4 years), in group 2 patients took NSAIDs and GC (n = 1608, women 89, 8%, age 50.4 + 14.6 years), in group 3 - only patients took GC (n=1135, women 92.7%, age 44.1 + 15.3 years). The detection of multiple erosions (>10, ME) and gastric and / or duodenal ulcers was as-sessed.
RESULTS: The frequency of ME and ulcers in patients of groups 1 and 2 did not differ significantly: 10.5% and 8.5%, odds ratio 0.799 (95% confidence interval 0.546-1.169, p=0.072). Risk factors, such as age > 65 years, ulcer history and low-dose aspirin, did not affect this pattern. The incidence of ME and ulcers was significantly lower in Group 3 patients than in Groups 1 and 2: 6.3% (p<0.001, p=0.032).
CONCLUSION: The use of GC does not increase the risk of erosion and ulcers of the upper GI tract when taking NSAIDs.
MATERIALS AND METHODS: A retrospective comparison was made of the incidence of gastrointestinal lesions detected in patients with RD during endoscopic examination in one medical center for 2007-2016. Three groups were formed: in group 1 patients took only NSAIDs (n=4823, women 80.7%, age 51.1 + 15.4 years), in group 2 patients took NSAIDs and GC (n = 1608, women 89, 8%, age 50.4 + 14.6 years), in group 3 - only patients took GC (n=1135, women 92.7%, age 44.1 + 15.3 years). The detection of multiple erosions (>10, ME) and gastric and / or duodenal ulcers was as-sessed.
RESULTS: The frequency of ME and ulcers in patients of groups 1 and 2 did not differ significantly: 10.5% and 8.5%, odds ratio 0.799 (95% confidence interval 0.546-1.169, p=0.072). Risk factors, such as age > 65 years, ulcer history and low-dose aspirin, did not affect this pattern. The incidence of ME and ulcers was significantly lower in Group 3 patients than in Groups 1 and 2: 6.3% (p<0.001, p=0.032).
CONCLUSION: The use of GC does not increase the risk of erosion and ulcers of the upper GI tract when taking NSAIDs.