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A case–control study of the risk of upper gastrointestinal mucosal injuries in patients prescribed concurrent NSAIDs and antithrombotic drugs based on data from the Japanese national claims database of 13 million accumulated patients

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A Correction to this article was published on 19 September 2018

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Abstract

Background

We aimed to identify the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and antithrombotics on the upper gastrointestinal (GI) mucosa in a clinical setting as a case–control study using a large-scale medical database in Japan.

Methods

We evaluated the risk of upper GI mucosal injuries in patients receiving NSAIDs and antithrombotics using the Japan Medical Data Center claims database with data for 13 million accumulated patients, from January 2009 to December 2014. Endoscopically evaluated upper GI mucosal injuries were peptic ulcers (n = 143,271), upper GI bleeding (n = 10,545), and gastroesophageal reflux disease (n = 154,755). For each patient, ten controls were matched by age, sex, and diagnosis month.

Results

The odds ratio (OR) for peptic ulcers was 1.45, 1.31, 1.50, 1.53, and 1.62; for upper GI bleeding: 1.76, 1.62, 1.96, 1.82, and 2.38; and for gastroesophageal reflux disease: 1.54, 1.41, 1.89, 1.67, and 1.91 for NSAIDs, COX-2 selective inhibitors, low-dose aspirin, antiplatelet drugs, and anticoagulants, respectively (all statistically significant: P < 0.001). Polypharmacy with NSAIDs and antithrombotic drugs increased the risk of upper GI injuries compared with single-drug therapy. The injury risk was also increased by lifestyle-related diseases, including diabetes mellitus and hyperlipidemia.

Conclusions

This case–control study using the large organized Japanese claims database provided the risk of upper GI mucosal injuries in patients receiving NSAIDs and antithrombotic drugs.

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Change history

  • 19 September 2018

    The authors would like to correct the errors in the publication of the original article. The correction details are given below for your reading.

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Acknowledgements

The authors would like to thank the Japan Medical Data Center Co., Ltd. for providing access to the claims database. Hideaki Miyagishi contributed to the statistical analysis. We thank Jane Charbonneau, DVM, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This study received no funding support.

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Authors and Affiliations

  1. Graduate School of Medical Science, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan

    Nobuyuki Sugisaki, Ryuichi Iwakiri, Shun Fujimoto, Yuichiro Eguchi & Kazuma Fujimoto

  2. Department of Internal Medicine, Saga University, Saga, 849-8501, Japan

    Nanae Tsuruoka, Yasuhisa Sakata, Ryo Shimoda, Shun Fujimoto, Yuichiro Eguchi & Kazuma Fujimoto

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  1. Nobuyuki Sugisaki
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  2. Ryuichi Iwakiri
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Correspondence to Nobuyuki Sugisaki.

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The authors declare no conflicts of interest regarding this study. Nobuyuki Sugisaki is an employee of EA Pharma Co., Ltd.

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Sugisaki, N., Iwakiri, R., Tsuruoka, N. et al. A case–control study of the risk of upper gastrointestinal mucosal injuries in patients prescribed concurrent NSAIDs and antithrombotic drugs based on data from the Japanese national claims database of 13 million accumulated patients. J Gastroenterol 53, 1253–1260 (2018). https://doi.org/10.1007/s00535-018-1483-x

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