SynthesisThrombosis and haemostasis2020
Risk of Bleeding with Exposure to Warfarin and Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review and Meta-Analysis.
Synthesis in Thrombosis and haemostasis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Nonsteroidal Anti-Inflammatory Drugs and Risk of Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis.Clinical pharmacology and therapeutics · 2026Pooled it
- Article
- A Descriptive Analysis of Potential Warfarin-NSAID Interactions in Dental Prescribing in Minas Gerais, Brazil, 2011-2021.Healthcare (Basel, Switzerland) · 2026Article
- Article
- Traumatic or Nontraumatic: A Case of Spinal Subdural Hematoma Caused by Multiple Factors.Clinical case reports · 2026Article
- Drug interaction between non-steroidal anti-inflammatory drugs and warfarin: a cross-sectional study.Clinical oral investigations · 2025Article
- Outcomes of Oral Anticoagulation with Concomitant NSAID Use: A Registry Based Cohort Study.The American journal of medicine · 2025Article
- Silent Dangers in Elderly Pharmacotherapy: The Interplay of Polypharmacy, Multimorbidity, and Drug Interactions.Journal of evaluation in clinical practice · 2025Review
- Patient reported pain following tooth extraction with different autologous platelet concentrates. Systematic review.BDJ open · 2025Article
- Naoxintong Is Involved in the Coagulation Regulation of Warfarin Through the MAPK Pathway.Pharmacogenomics and personalized medicine · 2025Article
- Impact of NSAID Use on Bleeding Rates for Patients Taking Rivaroxaban or Apixaban.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Real-World Bleeding Risk of Anticoagulant and Nonsteroidal Anti-inflammatory Drugs Combotherapy versus Anticoagulant Monotherapy.Gut and liver · 2024Article
- Clinical Implications of Polypharmacy for Patients with New-Onset Atrial Fibrillation Based on Real-World Data: Observations from the Korea National Health Insurance Service Data.Reviews in cardiovascular medicine · 2024Article
- Exploring safety and efficacy of rivaroxaban after living donor liver transplantation: a retrospective study.Langenbeck's archives of surgery · 2023Article
- Role of Cytochrome P450 2C9 in COVID-19 Treatment: Current Status and Future Directions.European journal of drug metabolism and pharmacokinetics · 2023Review
- Direct Oral Anticoagulants versus Vitamin K Antagonists in Individuals Aged 80 Years and Older: An Overview in 2021.International journal of environmental research and public health · 2023Article
- Does coprescribing nonsteroidal anti-inflammatory drugs and oral anticoagulants increase the risk of major bleeding, stroke and systemic embolism?British journal of clinical pharmacology · 2022Article
- Shared Decision-Making for Drug-Drug Interactions: Formative Evaluation of an Anticoagulant Drug Interaction.JMIR formative research · 2022Article
- Comparing the Efficacy and Safety of Apixaban Versus Warfarin in Morbidly Obese Patients.Cureus · 2022Article
- Ultrasound-guided injection with hyaluronic acid in hip osteoarthritis: efficacy and safety in a real-life setting.Clinical rheumatology · 2022Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundWarfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs).
objectivesThis article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone (Prospero Registry ID 145237).
methodsPubMed, EMBASE, Scopus, and Web of Science were searched. The primary outcome of interest was gastrointestinal bleeding and general bleeding. Summary effects were calculated to estimate average treatment effect using random effects models. Heterogeneity was assessed using Cochran's
resultsA total of 651 studies were identified, of which 11 studies met inclusion criteria for meta-analysis. The odds ratio (OR) for gastrointestinal bleeding when exposed to warfarin and an NSAID was 1.98 (95% confidence interval [CI]: 1.55-2.53). The risk of gastrointestinal bleeding was also significantly elevated with exposure to a COX-2 inhibitor and warfarin relative to warfarin alone (OR = 1.90, 95% CI: 1.46-2.46). There was an increased risk of general bleeding with the combination of warfarin with NSAIDs (OR = 1.58, 95% CI: 1.18-2.12) or COX-2 inhibitors (OR = 1.54, 95% CI: 0.86-2.78) compared with warfarin alone.
conclusionRisk of bleeding is significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone. It is important to caution patients about taking these medications in combination.
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What OpenQuestion holds
Registered trials
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.