ArticleJournal of gastroenterology2015
Effect of proton-pump inhibitors on the risk of lower gastrointestinal bleeding associated with NSAIDs, aspirin, clopidogrel, and warfarin.
Article in Journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Effect of aspirin, warfarin, and proton-pump inhibitors on performance of fecal immunochemical test in colorectal cancer screening: a systematic review and meta-analysis.Clinical and experimental medicine · 2023Pooled it
- Impact of proton pump inhibitors on the risk of small bowel or colorectal bleeding: A systematic review and meta-analysis.United European gastroenterology journal · 2023Pooled it
- Trial
- Relationship between Adverse Gastric Reactions and the Timing of Enteric-Coated Aspirin Administration.Clinical drug investigation · 2017Trial
- Pharmacovigilance analysis of small bowel bleeding associated with NSAIDs.Therapeutic advances in drug safety · 2025Article
- Widespread use of proton pump inhibitors or potassium-competitive acid blocker has changed the status of gastrointestinal bleeding in patients with ischemic heart disease: real-world data from high volume centers.BMC gastroenterology · 2024Article
- Severe Anemia from Multiple Gastric Hyperplastic Polyps in a Hemodialysis Patient after Long-term Use of a Proton-pump Inhibitor.Internal medicine (Tokyo, Japan) · 2024Article
- Proton pump inhibitors may enhance the risk of digestive diseases by regulating intestinal microbiota.Frontiers in pharmacology · 2023Review
- ViphyllinJournal of pain research · 2022Article
- Effect of Proton Pump Inhibitors on Risks of Upper and Lower Gastrointestinal Bleeding among Users of Low-Dose Aspirin: A Population-Based Observational Study.Journal of clinical medicine · 2020Article
- A prospective multicenter observational study evaluating the risk of periendoscopic events in patients using anticoagulants: the Osaka GIANT Study.Endoscopy international open · 2019Article
- Article
- Article
- Protons pump inhibitor treatment and lower gastrointestinal bleeding: Balancing risks and benefits.World journal of gastroenterology · 2016Article
- Effective and safe proton pump inhibitor therapy in acid-related diseases - A position paper addressing benefits and potential harms of acid suppression.BMC medicine · 2016Review
- Combined effect of proton-pump inhibitors and other drugs with regard to lower gastrointestinal tract bleeding with special reference to low-dose aspirin.Journal of gastroenterology · 2016Article
- Reply to the letter by Kawada entitled ''Combined effect of proton-pump inhibitors and other drugs with regard to lower gastrointestinal tract bleeding with special reference to low-dose aspirin''.Journal of gastroenterology · 2016Article
- Acute Middle Gastrointestinal Bleeding Risk Associated with NSAIDs, Antithrombotic Drugs, and PPIs: A Multicenter Case-Control Study.PloS one · 2016Article
- [Analgesics in geriatric patients. Adverse side effects and interactions].Zeitschrift fur Gerontologie und Geriatrie · 2015Article
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe investigated the effects of proton-pump inhibitors (PPIs) on lower gastrointestinal bleeding (LGIB) and of their interactions with nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, clopidogrel, and warfarin on LGIB risk.
methodsWe prospectively studied 355 patients emergently hospitalized for LGIB and 8,221 nonbleeding patients. All patients underwent colonoscopy. Smoking, alcohol drinking, drug exposure, and the Charlson comorbidity index score were assessed before colonoscopy. Adjusted odds ratios (AOR) of LGIB were estimated.
resultsLGIB was significantly associated with older age, higher comorbidity index, and NSAID, aspirin, clopidogrel, or warfarin use. PPI use was significantly associated with older age, male sex, being a current alcohol drinker, higher comorbidity index, and NSAID, aspirin, clopidogrel, warfarin, acetaminophen, or corticosteroid use. Multivariate analysis adjusted by the confounding factors revealed LGIB was not significantly associated with PPI use (AOR 0.87; 95 % confidence interval 0.68-1.13; p = 0.311), or specifically with omeprazole (AOR 1.18; p = 0.408), esomeprazole (AOR 0.76; p = 0.432), lansoprazole (AOR 0.93; p = 0.669), or rabeprazole (AOR 0.63; p = 0.140). In the interaction model, no significant interactions were observed between PPIs and NSAIDs (AOR 1.40; p = 0.293), aspirin (AOR 1.09; p = 0.767), clopidogrel (AOR 0.99, p = 0.985), or warfarin (AOR 1.52; p = 0.398).
conclusionsThis large case-control study demonstrated that PPI use did not lead to an increased risk of LGIB, regardless of the type of PPI used. Further, LGIB risk was not affected by PPI use, irrespective of concomitant therapy with NSAIDs, low-dose aspirin, clopidogrel, or warfarin.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.