Evidence map›Paper›PMID 30043109›Full record

ArticleEuropean journal of clinical pharmacology2018

Only full adherence to proton pump inhibitors protects against drug-induced upper gastrointestinal bleeding.

Borja Ruiz, Urko Aguirre, Ana Estany-Gestal, Luca Rodella, Pablo Ruiz, Adolfo Figueiras, Alfonso Carvajal, Luisa Ibáñez, Anita Conforti, Marian M de Pancorbo and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in European journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. NSAID, antiaggregant, and/or anticoagulant-related upper gastrointestinal bleeding: Is there any change in prophylaxis rate after a 10-year period?The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 3 countries.

Borja RuizUnidad de Farmacovigilancia del Pais Vasco, Galdakao-Usansolo Hospital, Barrio Labeaga 46A, 48960, Galdakao, Spain.
Urko AguirreResearch Unit, Research Network of Health Services in Chronic Diseases (REDISSEC), Galdakao-Usansolo Hospital, Galdakao, Spain.
Ana Estany-GestalDepartment of Preventive Medicine and Public Health, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain.
Luca Rodella1st Department of Surgery, Surgical Endoscopy Unit, University of Verona, Verona, Italy.
Pablo RuizDepartment of Digestive Diseases, Basurto University Hospital, Bilbao, Spain.
Adolfo FigueirasDepartment of Preventive Medicine and Public Health, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), University of Santiago de Compostela, Santiago de Compostela, Spain.
Alfonso CarvajalPharmacoepidemiology Institute, Department of Pharmacology, School of Medicine, University of Valladolid, Valladolid, Spain.
Luisa IbáñezCatalan Institute of Pharmacology, Clinical Pharmacology Service, University Hospital Vall d'Hebron, Department of Pharmacology, Therapeutics and Toxicology, Autonomous University, Barcelona, Spain.
Anita ConfortiClinical Pharmacology Unit, Department of Medicine and Public Health, University of Verona, Verona, Italy.
Marian M de PancorboGeneral Service of Genomic Research: DNA Bank, School of Pharmacy, University of the Basque Country, Vitoria-Gasteiz, Spain.
Xavier VidalCatalan Institute of Pharmacology, Clinical Pharmacology Service, University Hospital Vall d'Hebron, Department of Pharmacology, Therapeutics and Toxicology, Autonomous University, Barcelona, Spain.
Luis H MartinPharmacoepidemiology Institute, Department of Pharmacology, School of Medicine, University of Valladolid, Valladolid, Spain.
Carmelo AguirreUnidad de Farmacovigilancia del Pais Vasco, Galdakao-Usansolo Hospital, Barrio Labeaga 46A, 48960, Galdakao, Spain. carmelo.aguirregomez@osakidetza.eus.ORCID http://orcid.org/0000-0003-3555-1550
Hebron University · PSHospital de Galdakao · ESUniversidad de Valladolid · ESUniversidade de Santiago de Compostela · ESUniversity of the Basque Country · ESUniversity of Verona · ITHospital de Basurto · ES

Funding

Gobierno Vasco. Departamento de Salud 11/111103Gobierno Vasco. Departamento de Salud de salud 03/11092Instituto de Salud Carlos III PI02/0661Instituto de Salud Carlos III PI02/1364Instituto de Salud Carlos III PI02/1512Instituto de Salud Carlos III PI02/1572
6 · The paper itself

Abstract

purposeThe use of gastroprotective agents has allowed significant progress in the prevention of upper gastrointestinal bleeding (UGIB) associated with non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet agents. Nevertheless, some concerns remain regarding the gastroprotective dosage and treatment duration. Our aim was to study the effect of gastroprotective agents in UGIB induced by NSAIDs and single- or dual-antiplatelet therapy.

methodsA multicenter case-control study was conducted including 577 cases diagnosed with UGIB and 1343 sex-, age-, and hospital-matched controls. To estimate exposure to NSAIDs and gastroprotective agents, consumption was calculated for the 4 weeks prior to hospital admission in terms of defined daily doses (DDDs). Risk groups for UGIB induced by NSAIDs and single- or dual-antiplatelet therapy were defined as a function of each drug dose, use of gastrointestine-damaging drugs, and risk factors for UGIB. Odds ratios (ORs) with 95% confidence intervals (CIs) were adjusted for single- (model 1) and dual- (model 2) antiplatelet therapy.

resultsFull adherence (> 0.80DDD) to proton pump inhibitors (PPIs) was the only gastroprotective therapy that significantly reduced the risk of UGIB, considering NSAID risk (OR: 0.53; 95% CI: 0.30-0.95) and dose (OR: 0.48; 95% CI: 0.27-0.87) with ORs adjusted for single-antiplatelet therapy (model 1) and NSAID risk (OR: 0.55; 95% CI: 0.31-0.98) and dose (OR: 0.49; 95% CI: 0.28-0.89) with ORs adjusted for dual-antiplatelet therapy (model 2).

conclusionsThese results reinforce the recommendation of adding a PPI at effective doses (full adherence) to prevent UGIB induced by NSAIDs, or single- or dual-antiplatelet therapy.

Indexed as

Medication AdherenceAgedAnti-Inflammatory Agents, Non-SteroidalCase-Control StudiesDrug Therapy, CombinationFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedPlatelet Aggregation InhibitorsProton Pump InhibitorsRisk FactorsTreatment OutcomeAnti-Inflammatory Agents, Non-SteroidalPlatelet Aggregation InhibitorsProton Pump InhibitorsAcid-suppression therapyHemorrhageProspective case-controlUpper gastrointestinal

Identifiers

PMID30043109
OpenAlexW2884881292

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.