TY - JOUR
T1 - Risk factors for severe nonsteroidal anti-inflammatory drug-induced small intestinal damage
AU - Watanabe, Toshio
AU - Tanigawa, Tetsuya
AU - Nadatani, Yuji
AU - Nagami, Yasuaki
AU - Sugimori, Satoshi
AU - Okazaki, Hirotoshi
AU - Yamagami, Hirokazu
AU - Watanabe, Kenji
AU - Tominaga, Kazunari
AU - Fujiwara, Yasuhiro
AU - Koike, Tatsuya
AU - Arakawa, Tetsuo
PY - 2013/5
Y1 - 2013/5
N2 - Background: Few studies have assessed the risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced small intestinal damage. Aims: To evaluate the risk factors for NSAID-induced enteropathy in patients with rheumatoid arthritis. Methods: A cross-sectional study using capsule endoscopy was conducted. A total of 113 patients who took NSAIDs for over 3 months underwent capsule endoscopies. Endoscopic findings were scored as (0) normal, (1) red spots, (2) 1-4 erosions, (3) >4 erosions, or (4) large erosions/ulcers. Initial scores were grouped into 3 categories: No damage (0-1), mild damage (2), and severe damage (3-4), and the potential risk factors for damage development were assessed. Results: Five patients were excluded because of incomplete visualization of the entire small intestine. Fifty-two (47.2%) and 27 (25%) patients had no damage and mild damage, respectively, while the remaining 30 patients (27.8%) had severe damage and significantly decreased hemoglobin levels. In a multivariate logistic regression analysis, ages of 65 years or more (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.51-11.47), proton pump inhibitor usage (OR, 5.22; 95% CI, 1.36-20.11), and histamine H2 receptor antagonist usage (OR, 3.95; 95% CI, 1.28-12.25) were independent risk factors for severe damage. Conclusions: Elderly patients and acid suppressant users are more likely to develop severe NSAID-induced enteropathy.
AB - Background: Few studies have assessed the risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced small intestinal damage. Aims: To evaluate the risk factors for NSAID-induced enteropathy in patients with rheumatoid arthritis. Methods: A cross-sectional study using capsule endoscopy was conducted. A total of 113 patients who took NSAIDs for over 3 months underwent capsule endoscopies. Endoscopic findings were scored as (0) normal, (1) red spots, (2) 1-4 erosions, (3) >4 erosions, or (4) large erosions/ulcers. Initial scores were grouped into 3 categories: No damage (0-1), mild damage (2), and severe damage (3-4), and the potential risk factors for damage development were assessed. Results: Five patients were excluded because of incomplete visualization of the entire small intestine. Fifty-two (47.2%) and 27 (25%) patients had no damage and mild damage, respectively, while the remaining 30 patients (27.8%) had severe damage and significantly decreased hemoglobin levels. In a multivariate logistic regression analysis, ages of 65 years or more (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.51-11.47), proton pump inhibitor usage (OR, 5.22; 95% CI, 1.36-20.11), and histamine H2 receptor antagonist usage (OR, 3.95; 95% CI, 1.28-12.25) were independent risk factors for severe damage. Conclusions: Elderly patients and acid suppressant users are more likely to develop severe NSAID-induced enteropathy.
KW - Anemia
KW - Capsule endoscopy
KW - Proton pump inhibitor
UR - http://www.scopus.com/inward/record.url?scp=84876709049&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2012.12.005
DO - 10.1016/j.dld.2012.12.005
M3 - 学術論文
C2 - 23333664
AN - SCOPUS:84876709049
SN - 1590-8658
VL - 45
SP - 390
EP - 395
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
IS - 5
ER -