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Conference Paper: High-versus-low-dose histamine-2 antagonists for the prophylaxis of non-steroidal anti-infl ammatory drug-associated gastrointestinal ulcers

TitleHigh-versus-low-dose histamine-2 antagonists for the prophylaxis of non-steroidal anti-infl ammatory drug-associated gastrointestinal ulcers
Authors
Keywordsnon-steroidal anti-infl ammatory drugs (NSAIDs)
histamine-2-receptor antagonists (H2RAs)
gastrointestinal ulcers (GIUs)
Issue Date2013
PublisherThe Pharmaceutical Society of Hong Kong. The Journal's web site is located at http://www.pshk.hk/main.php?id=62
Citation
The 8th Asian Conference on Pharmacoepidemiology (ACPE 2013), Hong Kong, China, 25-27 October 2013. In Hong Kong Pharmaceutical Journal, 2013, v. 20 n. 3, p. 170 How to Cite?
AbstractAim/Objective: To compare the effectiveness of high-dose versus low-dose H2RAs in the primary prophylaxis of NSAID-associated clinical GIUs among NSAID new-users in Hong Kong during 2009-2012. Methods: A retrospective cohort study was conducted using Hong Kong Hospital Authority Clinical Data Analysis & Reporting System. Both records of new adult patients (18 years or older) who had only one prescription of NSAID+H2RA (exposure) and diagnosis code(s) of GIUs (event) during study period (2009-2012) were retrieved. Patients who were ever diagnosed with at least one of: GIUs, Helicobacter pylori infection, or who had ever received NSAIDs+H2RAs or NSAIDs+PPIs or had gastrointestinal endoscopy procedures in the screening period (2007-2008) were excluded. The high dose of H2RAs was defi ned as double the standard dose or higher, and the low dose was defi ned as lower than double dose (according to British National Formulary 63). The adjusted relative risk of GIUs during NSAID+high-dose-H2RA versus NSAID+low-dose-H2RA treatment was calculated. Microsoft Excel and Statistical Analysis System (SAS) v9.3 (SAS Inc., United States) were used for data manipulation and analysis. Results: A total of 102,042 patients had only one prescription of NSAIDs and were co-prescribed with H2RAs during 2009-2012. Among these patients, there were 77,509 patients on NSAID+low-dose-H2RA treatment and 24,533 patients on NSAID+high-dose- H2RA treatment. Of the total 70 GIUs events during study period, 65 GIUs events were found during NSAID+low-dose-H2RA treatment and 5 GIUs events were found during NSAID+high-dose-H2RA treatment. The adjusted relative risk for patients receiving NSAID+highdose- H2RA versus NSAID+low-dose-H2RA was 0.32 (95%CI 0.13-0.79). Conclusion: Our study support superior effectiveness of high-dose versus low-dose H2RAs in preventing NSAID-associated endoscopic GIUs. Further study involving international patient data will further inform on the place of high-dose H2RAs in clinical management.
DescriptionConference Theme: Applying pharmacoepidemiology to improve health care in Asia
Poster Presentation
Persistent Identifierhttp://hdl.handle.net/10722/204314
ISSN

 

DC FieldValueLanguage
dc.contributor.authorHe, Yen_US
dc.contributor.authorChan, EWen_US
dc.contributor.authorCheng, VCCen_US
dc.contributor.authorLau, CYen_US
dc.contributor.authorMan, KCKen_US
dc.contributor.authorWong, ICKen_US
dc.date.accessioned2014-09-19T22:23:44Z-
dc.date.available2014-09-19T22:23:44Z-
dc.date.issued2013en_US
dc.identifier.citationThe 8th Asian Conference on Pharmacoepidemiology (ACPE 2013), Hong Kong, China, 25-27 October 2013. In Hong Kong Pharmaceutical Journal, 2013, v. 20 n. 3, p. 170en_US
dc.identifier.issn1727-2874-
dc.identifier.urihttp://hdl.handle.net/10722/204314-
dc.descriptionConference Theme: Applying pharmacoepidemiology to improve health care in Asia-
dc.descriptionPoster Presentation-
dc.description.abstractAim/Objective: To compare the effectiveness of high-dose versus low-dose H2RAs in the primary prophylaxis of NSAID-associated clinical GIUs among NSAID new-users in Hong Kong during 2009-2012. Methods: A retrospective cohort study was conducted using Hong Kong Hospital Authority Clinical Data Analysis & Reporting System. Both records of new adult patients (18 years or older) who had only one prescription of NSAID+H2RA (exposure) and diagnosis code(s) of GIUs (event) during study period (2009-2012) were retrieved. Patients who were ever diagnosed with at least one of: GIUs, Helicobacter pylori infection, or who had ever received NSAIDs+H2RAs or NSAIDs+PPIs or had gastrointestinal endoscopy procedures in the screening period (2007-2008) were excluded. The high dose of H2RAs was defi ned as double the standard dose or higher, and the low dose was defi ned as lower than double dose (according to British National Formulary 63). The adjusted relative risk of GIUs during NSAID+high-dose-H2RA versus NSAID+low-dose-H2RA treatment was calculated. Microsoft Excel and Statistical Analysis System (SAS) v9.3 (SAS Inc., United States) were used for data manipulation and analysis. Results: A total of 102,042 patients had only one prescription of NSAIDs and were co-prescribed with H2RAs during 2009-2012. Among these patients, there were 77,509 patients on NSAID+low-dose-H2RA treatment and 24,533 patients on NSAID+high-dose- H2RA treatment. Of the total 70 GIUs events during study period, 65 GIUs events were found during NSAID+low-dose-H2RA treatment and 5 GIUs events were found during NSAID+high-dose-H2RA treatment. The adjusted relative risk for patients receiving NSAID+highdose- H2RA versus NSAID+low-dose-H2RA was 0.32 (95%CI 0.13-0.79). Conclusion: Our study support superior effectiveness of high-dose versus low-dose H2RAs in preventing NSAID-associated endoscopic GIUs. Further study involving international patient data will further inform on the place of high-dose H2RAs in clinical management.-
dc.languageengen_US
dc.publisherThe Pharmaceutical Society of Hong Kong. The Journal's web site is located at http://www.pshk.hk/main.php?id=62-
dc.relation.ispartofHong Kong Pharmaceutical Journalen_US
dc.subjectnon-steroidal anti-infl ammatory drugs (NSAIDs)-
dc.subjecthistamine-2-receptor antagonists (H2RAs)-
dc.subjectgastrointestinal ulcers (GIUs)-
dc.titleHigh-versus-low-dose histamine-2 antagonists for the prophylaxis of non-steroidal anti-infl ammatory drug-associated gastrointestinal ulcersen_US
dc.typeConference_Paperen_US
dc.identifier.emailHe, Y: helenhe@hku.hken_US
dc.identifier.emailChan, EW: ewchan@hku.hken_US
dc.identifier.emailCheng, VCC: vcccheng@hkucc.hku.hken_US
dc.identifier.emailLau, CY: wallisy@hku.hken_US
dc.identifier.emailMan, KCK: mkckth@hku.hken_US
dc.identifier.emailWong, ICK: wongick@hku.hken_US
dc.identifier.authorityChan, EW=rp01587en_US
dc.identifier.authorityWong, ICK=rp01480en_US
dc.identifier.hkuros239903en_US
dc.identifier.volume20en_US
dc.identifier.issue3en_US
dc.identifier.spage170en_US
dc.identifier.epage170en_US
dc.publisher.placeHong Kong-

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