BACKGROUND: A histamine-2 receptor antagonist (H2RA) is one of the common gastroprotective co-therapies used with non-steroidal anti-inflammatory drugs (NSAIDs) for the prevention or treatment of peptic ulcers (PUs). To date, no study has directly compared the prophylactic effectiveness between high-dose and low-dose H2RA. OBJECTIVE: Our objective was to compare the effectiveness of high-dose versus low-dose H2RAs in the primary prophylaxis of PUs among short-term NSAID users. METHODS: A retrospective cohort study was conducted using the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong. Patients aged 18 years or above who received a single prescription of oral NSAID with oral H2RA were identified within the study period (1 January 2009-31 December 2012). Patients with a history of or risk factors for PU in the corresponding 2 years prior to the index date (of the first NSAID prescription) were excluded. Log binomial regression analysis was used to calculate the relative risk of PU among NSAID users with high-dose H2RA versus low-dose H2RA exposure. RESULTS: Among the NSAID cohort (n = 102,042), 77,509 (76 %) were on low-dose H2RA and 24,533 (24 %) were on high-dose H2RA. Of the total 69 PU cases identified during the drug exposure period, 64 (0.08 %) received low-dose-H2RA and five (0.02 %) received high-dose H2RA. The overall absolute risk of PUs for NSAID users whilst on H2RA was approximately 1 per 1,479 patients. The adjusted relative risk for NSAID users receiving high-dose H2RA versus low-dose H2RA was 0.32 (95 % confidence interval [CI] 0.13-0.79). Patients aged ≥65 years, receiving a longer duration of treatment, or with concomitant use of antiplatelet agents were found to be at higher risk of PU. CONCLUSION: High-dose H2RA showed greater effectiveness than low-dose H2RA in the primary prophylaxis of NSAID-associated PUs in short-term new users.
BACKGROUND: A histamine-2 receptor antagonist (H2RA) is one of the common gastroprotective co-therapies used with non-steroidal anti-inflammatory drugs (NSAIDs) for the prevention or treatment of peptic ulcers (PUs). To date, no study has directly compared the prophylactic effectiveness between high-dose and low-dose H2RA. OBJECTIVE: Our objective was to compare the effectiveness of high-dose versus low-dose H2RAs in the primary prophylaxis of PUs among short-term NSAID users. METHODS: A retrospective cohort study was conducted using the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong. Patients aged 18 years or above who received a single prescription of oral NSAID with oral H2RA were identified within the study period (1 January 2009-31 December 2012). Patients with a history of or risk factors for PU in the corresponding 2 years prior to the index date (of the first NSAID prescription) were excluded. Log binomial regression analysis was used to calculate the relative risk of PU among NSAID users with high-dose H2RA versus low-dose H2RA exposure. RESULTS: Among the NSAID cohort (n = 102,042), 77,509 (76 %) were on low-dose H2RA and 24,533 (24 %) were on high-dose H2RA. Of the total 69 PU cases identified during the drug exposure period, 64 (0.08 %) received low-dose-H2RA and five (0.02 %) received high-dose H2RA. The overall absolute risk of PUs for NSAID users whilst on H2RA was approximately 1 per 1,479 patients. The adjusted relative risk for NSAID users receiving high-dose H2RA versus low-dose H2RA was 0.32 (95 % confidence interval [CI] 0.13-0.79). Patients aged ≥65 years, receiving a longer duration of treatment, or with concomitant use of antiplatelet agents were found to be at higher risk of PU. CONCLUSION: High-dose H2RA showed greater effectiveness than low-dose H2RA in the primary prophylaxis of NSAID-associated PUs in short-term new users.
Authors: Jung Mook Kang; Nayoung Kim; Byoung Hwan Lee; Hyun Kyung Park; Hyun Jin Jo; Cheol Min Shin; Sang Hyub Lee; Young Soo Park; Jin Hyeok Hwang; Jin Wook Kim; Sook-Hyang Jeong; Dong Ho Lee; Hyun Chae Jung; In Sung Song Journal: Scand J Gastroenterol Date: 2011-08-05 Impact factor: 2.423
Authors: N D Yeomans; Z Tulassay; L Juhász; I Rácz; J M Howard; C J van Rensburg; A J Swannell; C J Hawkey Journal: N Engl J Med Date: 1998-03-12 Impact factor: 91.245
Authors: Kenneth K C Man; David Coghill; Esther W Chan; Wallis C Y Lau; Chris Hollis; Elizabeth Liddle; Tobias Banaschewski; Suzanne McCarthy; Antje Neubert; Kapil Sayal; Patrick Ip; Martijn J Schuemie; Miriam C J M Sturkenboom; Edmund Sonuga-Barke; Jan Buitelaar; Sara Carucci; Alessandro Zuddas; Hanna Kovshoff; Peter Garas; Peter Nagy; Sarah K Inglis; Kerstin Konrad; Alexander Häge; Eric Rosenthal; Ian C K Wong Journal: JAMA Psychiatry Date: 2017-10-01 Impact factor: 21.596
Authors: Celine S L Chui; Esther W Chan; Angel Y S Wong; Adrian Root; Ian J Douglas; Ian C K Wong Journal: Neurology Date: 2016-04-06 Impact factor: 9.910
Authors: K K C Man; D Coghill; E W Chan; W C Y Lau; C Hollis; E Liddle; T Banaschewski; S McCarthy; A Neubert; K Sayal; P Ip; I C K Wong Journal: Transl Psychiatry Date: 2016-11-15 Impact factor: 6.222