TelematiV1, Ncbi, Merge, bibRecord, 000A29

Risk of upper gastrointestinal bleeding from different drug combinations.

Identifieur interne : 000A29 ( Ncbi/Merge ); précédent : 000A28; suivant : 000A30

Risk of upper gastrointestinal bleeding from different drug combinations.

Auteurs : Gwen M C. Masclee [Pays-Bas] ; Vera E. Valkhoff [Pays-Bas] ; Preciosa M. Coloma [Pays-Bas] ; Maria De Ridder [Pays-Bas] ; Silvana Romio [Pays-Bas] ; Martijn J. Schuemie [Pays-Bas] ; Ron Herings [Pays-Bas] ; Rosa Gini [Italie] ; Giampiero Mazzaglia [Italie] ; Gino Picelli [Italie] ; Lorenza Scotti [Italie] ; Lars Pedersen [Danemark] ; Ernst J. Kuipers [Pays-Bas] ; Johan Van Der Lei [Pays-Bas] ; Miriam C J M. Sturkenboom [Pays-Bas]

Source :

Gastroenterology [ 1528-0012 ] ; 2014.

RBID : pubmed:24937265

Descripteurs français

English descriptors

KwdEn :
- Adrenal Cortex Hormones (adverse effects), Anti-Inflammatory Agents, Non-Steroidal (administration & dosage), Anti-Inflammatory Agents, Non-Steroidal (adverse effects), Anticoagulants (adverse effects), Aspirin (administration & dosage), Aspirin (adverse effects), Cyclooxygenase Inhibitors (administration & dosage), Cyclooxygenase Inhibitors (adverse effects), Dose-Response Relationship, Drug, Drug Interactions, Europe, Gastrointestinal Hemorrhage (chemically induced), Humans, Mineralocorticoid Receptor Antagonists (adverse effects), Risk Assessment, Risk Factors.
MESH :
- chemical , administration & dosage : Anti-Inflammatory Agents, Non-Steroidal, Aspirin, Cyclooxygenase Inhibitors.
- chemical , adverse effects : Adrenal Cortex Hormones, Anti-Inflammatory Agents, Non-Steroidal, Anticoagulants, Aspirin, Cyclooxygenase Inhibitors, Mineralocorticoid Receptor Antagonists.
- geographic : Europe.
- chemically induced : Gastrointestinal Hemorrhage.
- Dose-Response Relationship, Drug, Drug Interactions, Humans, Risk Assessment, Risk Factors.

Abstract

Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin increases the risk of upper gastrointestinal bleeding (UGIB). Guidelines suggest avoiding certain drug combinations, yet little is known about the magnitude of their interactions. We estimated the risk of UGIB during concomitant use of nonselective (ns)NSAIDs, cyclooxygenase -2 selective inhibitors (COX-2 inhibitors), and low-dose aspirin with other drugs.

DOI: 10.1053/j.gastro.2014.06.007
PubMed: 24937265

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Le document en format XML

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<author><name sortKey="Sturkenboom, Miriam C J M" sort="Sturkenboom, Miriam C J M" uniqKey="Sturkenboom M" first="Miriam C J M" last="Sturkenboom">Miriam C J M. Sturkenboom</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam</wicri:regionArea>
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<country xml:lang="fr">Pays-Bas</country>
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<author><name sortKey="Romio, Silvana" sort="Romio, Silvana" uniqKey="Romio S" first="Silvana" last="Romio">Silvana Romio</name>
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<country xml:lang="fr">Pays-Bas</country>
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<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Medical Informatics, Erasmus Medical Center, Rotterdam</wicri:regionArea>
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<author><name sortKey="Herings, Ron" sort="Herings, Ron" uniqKey="Herings R" first="Ron" last="Herings">Ron Herings</name>
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<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; PHARMO Institute, Utrecht</wicri:regionArea>
<placeName><settlement type="city">Utrecht</settlement>
<region nuts="2" type="province">Utrecht (province)</region>
</placeName>
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<author><name sortKey="Gini, Rosa" sort="Gini, Rosa" uniqKey="Gini R" first="Rosa" last="Gini">Rosa Gini</name>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Agenzi Regionali di Sanità della Toscana, Florence</wicri:regionArea>
<wicri:noRegion>Florence</wicri:noRegion>
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<author><name sortKey="Mazzaglia, Giampiero" sort="Mazzaglia, Giampiero" uniqKey="Mazzaglia G" first="Giampiero" last="Mazzaglia">Giampiero Mazzaglia</name>
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<country xml:lang="fr">Italie</country>
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<author><name sortKey="Picelli, Gino" sort="Picelli, Gino" uniqKey="Picelli G" first="Gino" last="Picelli">Gino Picelli</name>
<affiliation wicri:level="1"><nlm:affiliation>Pedianet, Societá Servizi Telematici SRL, Padova, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Pedianet, Societá Servizi Telematici SRL, Padova</wicri:regionArea>
<wicri:noRegion>Padova</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Scotti, Lorenza" sort="Scotti, Lorenza" uniqKey="Scotti L" first="Lorenza" last="Scotti">Lorenza Scotti</name>
<affiliation wicri:level="3"><nlm:affiliation>Università degli Studi di Milano-Bicocca, Milan, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Università degli Studi di Milano-Bicocca, Milan</wicri:regionArea>
<placeName><settlement type="city">Milan</settlement>
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</affiliation>
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<author><name sortKey="Pedersen, Lars" sort="Pedersen, Lars" uniqKey="Pedersen L" first="Lars" last="Pedersen">Lars Pedersen</name>
<affiliation wicri:level="1"><nlm:affiliation>Clinical Epidemiology, Aarhus University Hospital, Århus Sygehus, Aarhus, Denmark.</nlm:affiliation>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Clinical Epidemiology, Aarhus University Hospital, Århus Sygehus, Aarhus</wicri:regionArea>
<wicri:noRegion>Aarhus</wicri:noRegion>
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<author><name sortKey="Kuipers, Ernst J" sort="Kuipers, Ernst J" uniqKey="Kuipers E" first="Ernst J" last="Kuipers">Ernst J. Kuipers</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam</wicri:regionArea>
<placeName><settlement type="city">Rotterdam</settlement>
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<author><name sortKey="Van Der Lei, Johan" sort="Van Der Lei, Johan" uniqKey="Van Der Lei J" first="Johan" last="Van Der Lei">Johan Van Der Lei</name>
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<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Medical Informatics, Erasmus Medical Center, Rotterdam</wicri:regionArea>
<placeName><settlement type="city">Rotterdam</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
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<author><name sortKey="Sturkenboom, Miriam C J M" sort="Sturkenboom, Miriam C J M" uniqKey="Sturkenboom M" first="Miriam C J M" last="Sturkenboom">Miriam C J M. Sturkenboom</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam</wicri:regionArea>
<placeName><settlement type="city">Rotterdam</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Gastroenterology</title>
<idno type="eISSN">1528-0012</idno>
<imprint><date when="2014" type="published">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenal Cortex Hormones (adverse effects)</term>
<term>Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)</term>
<term>Anti-Inflammatory Agents, Non-Steroidal (adverse effects)</term>
<term>Anticoagulants (adverse effects)</term>
<term>Aspirin (administration & dosage)</term>
<term>Aspirin (adverse effects)</term>
<term>Cyclooxygenase Inhibitors (administration & dosage)</term>
<term>Cyclooxygenase Inhibitors (adverse effects)</term>
<term>Dose-Response Relationship, Drug</term>
<term>Drug Interactions</term>
<term>Europe</term>
<term>Gastrointestinal Hemorrhage (chemically induced)</term>
<term>Humans</term>
<term>Mineralocorticoid Receptor Antagonists (adverse effects)</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Acide acétylsalicylique (administration et posologie)</term>
<term>Acide acétylsalicylique (effets indésirables)</term>
<term>Antagonistes des récepteurs des minéralocorticoïdes (effets indésirables)</term>
<term>Anti-inflammatoires non stéroïdiens (administration et posologie)</term>
<term>Anti-inflammatoires non stéroïdiens (effets indésirables)</term>
<term>Anticoagulants (effets indésirables)</term>
<term>Europe</term>
<term>Facteurs de risque</term>
<term>Hormones corticosurrénaliennes (effets indésirables)</term>
<term>Humains</term>
<term>Hémorragie gastro-intestinale ()</term>
<term>Inhibiteurs des cyclooxygénases (administration et posologie)</term>
<term>Inhibiteurs des cyclooxygénases (effets indésirables)</term>
<term>Interactions médicamenteuses</term>
<term>Relation dose-effet des médicaments</term>
<term>Évaluation des risques</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-Inflammatory Agents, Non-Steroidal</term>
<term>Aspirin</term>
<term>Cyclooxygenase Inhibitors</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Adrenal Cortex Hormones</term>
<term>Anti-Inflammatory Agents, Non-Steroidal</term>
<term>Anticoagulants</term>
<term>Aspirin</term>
<term>Cyclooxygenase Inhibitors</term>
<term>Mineralocorticoid Receptor Antagonists</term>
</keywords>
<keywords scheme="MESH" type="geographic" xml:lang="en"><term>Europe</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Acide acétylsalicylique</term>
<term>Anti-inflammatoires non stéroïdiens</term>
<term>Inhibiteurs des cyclooxygénases</term>
</keywords>
<keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Gastrointestinal Hemorrhage</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Acide acétylsalicylique</term>
<term>Antagonistes des récepteurs des minéralocorticoïdes</term>
<term>Anti-inflammatoires non stéroïdiens</term>
<term>Anticoagulants</term>
<term>Hormones corticosurrénaliennes</term>
<term>Inhibiteurs des cyclooxygénases</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Dose-Response Relationship, Drug</term>
<term>Drug Interactions</term>
<term>Humans</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Europe</term>
<term>Facteurs de risque</term>
<term>Humains</term>
<term>Hémorragie gastro-intestinale</term>
<term>Interactions médicamenteuses</term>
<term>Relation dose-effet des médicaments</term>
<term>Évaluation des risques</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin increases the risk of upper gastrointestinal bleeding (UGIB). Guidelines suggest avoiding certain drug combinations, yet little is known about the magnitude of their interactions. We estimated the risk of UGIB during concomitant use of nonselective (ns)NSAIDs, cyclooxygenase -2 selective inhibitors (COX-2 inhibitors), and low-dose aspirin with other drugs.</div>
</front>
</TEI>
<pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">24937265</PMID>
<DateCreated><Year>2014</Year>
<Month>09</Month>
<Day>20</Day>
</DateCreated>
<DateCompleted><Year>2014</Year>
<Month>11</Month>
<Day>25</Day>
</DateCompleted>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1528-0012</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>147</Volume>
<Issue>4</Issue>
<PubDate><Year>2014</Year>
<Month>Oct</Month>
</PubDate>
</JournalIssue>
<Title>Gastroenterology</Title>
<ISOAbbreviation>Gastroenterology</ISOAbbreviation>
</Journal>
<ArticleTitle>Risk of upper gastrointestinal bleeding from different drug combinations.</ArticleTitle>
<Pagination><MedlinePgn>784-792.e9; quiz e13-4</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1053/j.gastro.2014.06.007</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0016-5085(14)00768-9</ELocationID>
<Abstract><AbstractText Label="BACKGROUND & AIMS" NlmCategory="OBJECTIVE">Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin increases the risk of upper gastrointestinal bleeding (UGIB). Guidelines suggest avoiding certain drug combinations, yet little is known about the magnitude of their interactions. We estimated the risk of UGIB during concomitant use of nonselective (ns)NSAIDs, cyclooxygenase -2 selective inhibitors (COX-2 inhibitors), and low-dose aspirin with other drugs.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We performed a case series analysis of data from 114,835 patients with UGIB (930,888 person-years of follow-up) identified from 7 population-based health care databases (approximately 20 million subjects). Each patient served as his or her own control. Drug exposure was determined based on prescriptions of nsNSAIDs, COX-2 inhibitors, or low-dose aspirin, alone and in combination with other drugs that affect the risk of UGIB. We measured relative risk (incidence rate ratio [IRR] during drug exposure vs nonexposure) and excess risk due to concomitant drug exposure (relative excess risk due to interaction [RERI]).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Monotherapy with nsNSAIDs increased the risk of diagnosis of UGIB (IRR, 4.3) to a greater extent than monotherapy with COX-2 inhibitors (IRR, 2.9) or low-dose aspirin (IRR, 3.1). Combination therapy generally increased the risk of UGIB; concomitant nsNSAID and corticosteroid therapies increased the IRR to the greatest extent (12.8) and also produced the greatest excess risk (RERI, 5.5). Concomitant use of nsNSAIDs and aldosterone antagonists produced an IRR for UGIB of 11.0 (RERI, 4.5). Excess risk from concomitant use of nsNSAIDs with selective serotonin reuptake inhibitors (SSRIs) was 1.6, whereas that from use of COX-2 inhibitors with SSRIs was 1.9 and that for use of low-dose aspirin with SSRIs was 0.5. Excess risk of concomitant use of nsNSAIDs with anticoagulants was 2.4, of COX-2 inhibitors with anticoagulants was 0.1, and of low-dose aspirin with anticoagulants was 1.9.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Based on a case series analysis, concomitant use of nsNSAIDs, COX-2 inhibitors, or low-dose aspirin with SSRIs significantly increases the risk of UGIB. Concomitant use of nsNSAIDs or low-dose aspirin, but not COX-2 inhibitors, with corticosteroids, aldosterone antagonists, or anticoagulants produces significant excess risk of UGIB.</AbstractText>
<CopyrightInformation>Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Masclee</LastName>
<ForeName>Gwen M C</ForeName>
<Initials>GM</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: g.masclee@erasmusmc.nl.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Valkhoff</LastName>
<ForeName>Vera E</ForeName>
<Initials>VE</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Coloma</LastName>
<ForeName>Preciosa M</ForeName>
<Initials>PM</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>de Ridder</LastName>
<ForeName>Maria</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Romio</LastName>
<ForeName>Silvana</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schuemie</LastName>
<ForeName>Martijn J</ForeName>
<Initials>MJ</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Herings</LastName>
<ForeName>Ron</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; PHARMO Institute, Utrecht, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gini</LastName>
<ForeName>Rosa</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Agenzi Regionali di Sanità della Toscana, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mazzaglia</LastName>
<ForeName>Giampiero</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Health Search, Italian College of General Practitioners, Florence, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Picelli</LastName>
<ForeName>Gino</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Pedianet, Societá Servizi Telematici SRL, Padova, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Scotti</LastName>
<ForeName>Lorenza</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Università degli Studi di Milano-Bicocca, Milan, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pedersen</LastName>
<ForeName>Lars</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Clinical Epidemiology, Aarhus University Hospital, Århus Sygehus, Aarhus, Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kuipers</LastName>
<ForeName>Ernst J</ForeName>
<Initials>EJ</Initials>
<AffiliationInfo><Affiliation>Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>van der Lei</LastName>
<ForeName>Johan</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sturkenboom</LastName>
<ForeName>Miriam C J M</ForeName>
<Initials>MC</Initials>
<AffiliationInfo><Affiliation>Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
<PublicationType UI="D057405">Webcasts</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2014</Year>
<Month>06</Month>
<Day>14</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Gastroenterology</MedlineTA>
<NlmUniqueID>0374630</NlmUniqueID>
<ISSNLinking>0016-5085</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000305">Adrenal Cortex Hormones</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000894">Anti-Inflammatory Agents, Non-Steroidal</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000925">Anticoagulants</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D016861">Cyclooxygenase Inhibitors</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000451">Mineralocorticoid Receptor Antagonists</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>R16CO5Y76E</RegistryNumber>
<NameOfSubstance UI="D001241">Aspirin</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Gastroenterology. 2014 Oct;147(4):730-3</RefSource>
<PMID Version="1">25167988</PMID>
</CommentsCorrections>
</CommentsCorrectionsList>
<MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000305">Adrenal Cortex Hormones</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000894">Anti-Inflammatory Agents, Non-Steroidal</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000008">administration & dosage</QualifierName>
<QualifierName MajorTopicYN="Y" UI="Q000009">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000925">Anticoagulants</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D001241">Aspirin</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000008">administration & dosage</QualifierName>
<QualifierName MajorTopicYN="Y" UI="Q000009">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D016861">Cyclooxygenase Inhibitors</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000008">administration & dosage</QualifierName>
<QualifierName MajorTopicYN="Y" UI="Q000009">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D004305">Dose-Response Relationship, Drug</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D004347">Drug Interactions</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" Type="Geographic" UI="D005060">Europe</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D006471">Gastrointestinal Hemorrhage</DescriptorName>
<QualifierName MajorTopicYN="Y" UI="Q000139">chemically induced</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000451">Mineralocorticoid Receptor Antagonists</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D018570">Risk Assessment</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D012307">Risk Factors</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Prostaglandin</Keyword>
<Keyword MajorTopicYN="N">Side Effects</Keyword>
<Keyword MajorTopicYN="N">Stomach</Keyword>
<Keyword MajorTopicYN="N">Treatment</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2013</Year>
<Month>9</Month>
<Day>2</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2014</Year>
<Month>5</Month>
<Day>22</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2014</Year>
<Month>6</Month>
<Day>11</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="aheadofprint"><Year>2014</Year>
<Month>6</Month>
<Day>14</Day>
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<PubMedPubDate PubStatus="entrez"><Year>2014</Year>
<Month>6</Month>
<Day>18</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2014</Year>
<Month>6</Month>
<Day>18</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2014</Year>
<Month>12</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">24937265</ArticleId>
<ArticleId IdType="pii">S0016-5085(14)00768-9</ArticleId>
<ArticleId IdType="doi">10.1053/j.gastro.2014.06.007</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>Danemark</li>
<li>Italie</li>
<li>Pays-Bas</li>
</country>
<region><li>Hollande-Méridionale</li>
<li>Lombardie</li>
<li>Utrecht (province)</li>
</region>
<settlement><li>Milan</li>
<li>Rotterdam</li>
<li>Utrecht</li>
</settlement>
</list>
<tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Masclee, Gwen M C" sort="Masclee, Gwen M C" uniqKey="Masclee G" first="Gwen M C" last="Masclee">Gwen M C. Masclee</name>
</region>
<name sortKey="Coloma, Preciosa M" sort="Coloma, Preciosa M" uniqKey="Coloma P" first="Preciosa M" last="Coloma">Preciosa M. Coloma</name>
<name sortKey="De Ridder, Maria" sort="De Ridder, Maria" uniqKey="De Ridder M" first="Maria" last="De Ridder">Maria De Ridder</name>
<name sortKey="Herings, Ron" sort="Herings, Ron" uniqKey="Herings R" first="Ron" last="Herings">Ron Herings</name>
<name sortKey="Kuipers, Ernst J" sort="Kuipers, Ernst J" uniqKey="Kuipers E" first="Ernst J" last="Kuipers">Ernst J. Kuipers</name>
<name sortKey="Romio, Silvana" sort="Romio, Silvana" uniqKey="Romio S" first="Silvana" last="Romio">Silvana Romio</name>
<name sortKey="Schuemie, Martijn J" sort="Schuemie, Martijn J" uniqKey="Schuemie M" first="Martijn J" last="Schuemie">Martijn J. Schuemie</name>
<name sortKey="Sturkenboom, Miriam C J M" sort="Sturkenboom, Miriam C J M" uniqKey="Sturkenboom M" first="Miriam C J M" last="Sturkenboom">Miriam C J M. Sturkenboom</name>
<name sortKey="Valkhoff, Vera E" sort="Valkhoff, Vera E" uniqKey="Valkhoff V" first="Vera E" last="Valkhoff">Vera E. Valkhoff</name>
<name sortKey="Van Der Lei, Johan" sort="Van Der Lei, Johan" uniqKey="Van Der Lei J" first="Johan" last="Van Der Lei">Johan Van Der Lei</name>
</country>
<country name="Italie"><noRegion><name sortKey="Gini, Rosa" sort="Gini, Rosa" uniqKey="Gini R" first="Rosa" last="Gini">Rosa Gini</name>
</noRegion>
<name sortKey="Mazzaglia, Giampiero" sort="Mazzaglia, Giampiero" uniqKey="Mazzaglia G" first="Giampiero" last="Mazzaglia">Giampiero Mazzaglia</name>
<name sortKey="Picelli, Gino" sort="Picelli, Gino" uniqKey="Picelli G" first="Gino" last="Picelli">Gino Picelli</name>
<name sortKey="Scotti, Lorenza" sort="Scotti, Lorenza" uniqKey="Scotti L" first="Lorenza" last="Scotti">Lorenza Scotti</name>
</country>
<country name="Danemark"><noRegion><name sortKey="Pedersen, Lars" sort="Pedersen, Lars" uniqKey="Pedersen L" first="Lars" last="Pedersen">Lars Pedersen</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Risk of upper gastrointestinal bleeding from different drug combinations.

Risk of upper gastrointestinal bleeding from different drug combinations.

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