ArticleDrug safety2008
NSAID use in individuals at risk of renal adverse events: an observational study to investigate trends in Australian veterans.
Article in Drug safety, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 20 citations in OpenAlex.
- Progress in PET Imaging of Neuroinflammation Targeting COX-2 Enzyme.Molecules (Basel, Switzerland) · 2021Review
- Type 2 diabetes mellitus and osteoarthritis.Seminars in arthritis and rheumatism · 2019Review
- The use and impact of cancer medicines in routine clinical care: methods and observations in a cohort of elderly Australians.BMJ open · 2014Article
- COX-2 inhibitor and non-selective NSAID use in those at increased risk of NSAID-related adverse events: a retrospective database study.Drugs & aging · 2013Article
- An observational study of the discrediting of COX-2 NSAIDs in Australia: Vioxx or class effect?BMC public health · 2011Article
- Cause for concern in the use of non-steroidal anti-inflammatory medications in the community--a population-based study.BMC family practice · 2011Article
- Differential impact of NSAIDs on rate of adverse events that require hospitalization in high-risk and general veteran populations: a retrospective cohort study.Drugs & aging · 2010Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCyclo-oxygenase (COX)-2 inhibitors were introduced to world markets with claims of improved gastrointestinal safety compared with traditional NSAIDs. Randomized clinical trials had demonstrated fewer adverse gastrointestinal events with COX-2 inhibitors, but no difference with other adverse events, including adverse renal events. There was a rapid uptake of these medicines.
objectiveTo compare uptake rates of NSAIDs, including COX-2 inhibitors, in a reference population with those in two high-risk populations: a population taking medicines affecting the renin-angiotensin system and loop diuretics, and a population taking medicines for diabetes mellitus.
methodAn observational study was undertaken in which the Department of Veterans' Affairs claims dataset was used to identify: veterans dispensed ACE inhibitors (ACEIs) or angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]) and furosemide (ACEI-ARB/furosemide cohort); veterans dispensed medicines for diabetes (diabetes cohort); and all other veterans (reference cohort) from July 1999 to July 2007. Concurrent dispensing of NSAIDs was assessed.
resultsPrior to celecoxib becoming subsidized in Australia, the baseline level of NSAID use was 19.5% in the reference cohort, 15.3% in the diabetes cohort and 15.6% in the ACEI-ARB/furosemide cohort. After the listing of celecoxib, utilization of NSAIDs increased by 42.2% in the reference cohort, with similar increases in the diabetes cohort (40.8%; p = 0.88 compared with the reference cohort) and the ACEI-ARB/furosemide cohort (49.6%; p = 0.09 compared with the reference cohort). With the withdrawal of rofecoxib, utilization of NSAIDs in the reference cohort fell by 25.3%, with similar falls in the diabetes cohort (24%; p = 0.28 compared with the reference cohort) and the ACEI-ARB/furosemide cohort (26.1%; p = 0.43 compared with the reference cohort).
conclusionsDespite the increased vulnerability of veterans receiving ACEI-ARB/furosemide or diabetes medicines to adverse events of NSAIDs, uptake rates of COX inhibitors were equivalent to the rest of the veteran population. This suggests the gastrointestinal safety messages were interpreted broadly by prescribers and the adverse renal effects were not considered.
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