(HealthDay News) – For patients taking cyclooxygenase-2 inhibitors (coxibs), low adherence to gastroprotective agents (GPAs) increases the risk of upper gastrointestinal (UGI) complications.

Vera E. Valkhoff, from Erasmus University Medical Centre in Rotterdam, Netherlands, and colleagues conducted a case-control study using data from 14,416 newly started coxib users (aged ≥50 years) from three European databases who simultaneously used GPAs. Cases with UGI events, including bleeding or symptomatic ulcer, were age-, gender-, database-, and calendar date-matched to event-free controls. The Proportion of coxib treatment Days Covered by a GPA prescription (PDC) was used as a measure of adherence to GPAs.

The researchers found that there were 16,442 coxib+GPA episodes, with the majority of patients using coxibs for <30 days. During or shortly after these episodes, 74 patients had an UGI event, with an incidence rate of 11.9 per 1,000 coxib user years. Compared with full adherers (PDC, >80%), low GPA adherers (PDC, <20%) had an increased risk of UGI events (odds ratio [OR], 1.97; 95% confidence interval [CI], 0.84–4.6). The risk of UGI events increased by 9% for every 10% decrease in GPA adherence (OR, 1.09; 95% CI, 1–1.18).

“Decreasing GPA adherence among coxib users is associated with an increased risk of UGI events,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including AstraZeneca, which funded the study.

Full Text (subscription or payment may be required)