Mai Duong1,2,3, Abdelilah Abouelfath1, Regis Lassalle1, Cécile Droz1, Patrick Blin1, Nicholas Moore4,5. 1. Bordeaux PharmacoEpi, INSERM CIC1401, University of Bordeaux, CHU de Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France. 2. INSERM U1219, 33076, Bordeaux, France. 3. OXON Epidemiology, London, UK. 4. Bordeaux PharmacoEpi, INSERM CIC1401, University of Bordeaux, CHU de Bordeaux, 146 rue Leo Saignat, 33076, Bordeaux, France. nicholas.moore@u-bordeaux.fr. 5. INSERM U1219, 33076, Bordeaux, France. nicholas.moore@u-bordeaux.fr.
Abstract
INTRODUCTION: Non-steroidal anti-inflammatory drugs are associated with a dose and duration-dependent coronary risk. There is little information concerning analgesic-dose ibuprofen, among the most widely used drugs worldwide. OBJECTIVE: Our objective was to measure the risks of acute coronary syndrome (ACS) after dispensing of ibuprofen, versus paracetamol. METHODS: Propensity score 1:2-matched cohorts of ibuprofen or paracetamol treatment episodes (TEs) in Echantillon Généraliste de Bénéficiaires (EGB), the 1/97 sample of Système National des Données de Santé (SNDS), the French nationwide claims database, from 2009 to 2014, were compared. Outcomes were hospital admissions for ACS during the 3 months after the dispensing of ibuprofen or paracetamol. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated overall and stratified on low-dose aspirin dispensing. RESULTS: A total of 315,269 ibuprofen TEs in 168,400 persons were matched to 630,457 paracetamol TEs in 395,952 patients. Event rates were 50-100 times higher in low-dose aspirin users (27 vs 0.28 per 1000 patient years). Overall there was no difference in risk of ACS at 3 months (HR 0.94, 95% CI 0.74-1.20) despite a transient increase in the first 2 weeks in ibuprofen users (HR 1.70, 95% CI 1.11-2.59). In the stratified analysis, this short-term risk was only found in aspirin users (5% of population, HR 1.84, 95% CI 1.24-3.24), but not in non-aspirin users (HR 1.09, 95% CI 0.40-2.94). CONCLUSIONS: There was no evidence for an increased risk of ACS in patients dispensed ibuprofen compared to paracetamol.
INTRODUCTION: Non-steroidal anti-inflammatory drugs are associated with a dose and duration-dependent coronary risk. There is little information concerning analgesic-dose ibuprofen, among the most widely used drugs worldwide. OBJECTIVE: Our objective was to measure the risks of acute coronary syndrome (ACS) after dispensing of ibuprofen, versus paracetamol. METHODS: Propensity score 1:2-matched cohorts of ibuprofen or paracetamol treatment episodes (TEs) in Echantillon Généraliste de Bénéficiaires (EGB), the 1/97 sample of Système National des Données de Santé (SNDS), the French nationwide claims database, from 2009 to 2014, were compared. Outcomes were hospital admissions for ACS during the 3 months after the dispensing of ibuprofen or paracetamol. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated overall and stratified on low-dose aspirin dispensing. RESULTS: A total of 315,269 ibuprofen TEs in 168,400 persons were matched to 630,457 paracetamol TEs in 395,952 patients. Event rates were 50-100 times higher in low-dose aspirin users (27 vs 0.28 per 1000 patient years). Overall there was no difference in risk of ACS at 3 months (HR 0.94, 95% CI 0.74-1.20) despite a transient increase in the first 2 weeks in ibuprofen users (HR 1.70, 95% CI 1.11-2.59). In the stratified analysis, this short-term risk was only found in aspirin users (5% of population, HR 1.84, 95% CI 1.24-3.24), but not in non-aspirin users (HR 1.09, 95% CI 0.40-2.94). CONCLUSIONS: There was no evidence for an increased risk of ACS in patients dispensed ibuprofen compared to paracetamol.
Authors: Mai Duong; Francesco Salvo; Antoine Pariente; Abdelilah Abouelfath; Regis Lassalle; Cecile Droz; Patrick Blin; Nicholas Moore Journal: Br J Clin Pharmacol Date: 2014-05 Impact factor: 4.335
Authors: Nicholas Moore; Sinem Ezgi Gulmez; Dominique Larrey; Georges-Philippe Pageaux; Séverine Lignot; Régis Lassalle; Jérémy Jové; Antoine Pariente; Patrick Blin; Jacques Bénichou; Bernard Bégaud Journal: Pharmacoepidemiol Drug Saf Date: 2012-11-20 Impact factor: 2.890
Authors: David Laharie; Cécile Droz-Perroteau; Jacques Bénichou; Michel Amouretti; Patrick Blin; Bernard Bégaud; Estelle Guiard; Sylvie Dutoit; Stéphanie Lamarque; Yola Moride; Fanny Depont; Annie Fourrier-Réglat; Nicholas Moore Journal: Br J Clin Pharmacol Date: 2010-03 Impact factor: 4.335
Authors: P García-Poza; F J de Abajo; M J Gil; A Chacón; V Bryant; L A García-Rodríguez Journal: J Thromb Haemost Date: 2015-02-24 Impact factor: 5.824