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Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study
  1. Angel Lanas1,
  2. Jesús Tornero2,
  3. José Luis Zamorano3
  1. 1Universidad de Zaragoza, Servicio de Aparato Digestivo, Hospital Clínico, CIBERehd, I+CS, Zaragoza, Spain
  2. 2Servicio de Reumatología, Hospital General Universitario de Guadalajara, Guadalajara, Spain
  3. 3Servicio de Cardiología, Hospital San Carlos, Madrid, Spain
  1. Correspondence to Professor Angel Lanas, Servicio de Aparato Digestivo, Hospital Clínico Universitario, c/ Domingo MIral s/n, Zaragoza 50009, Spain; alanas{at}unizar.es

Abstract

Background Medical management of adults with osteoarthritis (OA) who require non-steroidal anti-inflammatory drugs (NSAIDs) must be decided after assessing prevalent gastrointestinal (GI) and cardiovascular (CV) risks in the individual patient.

Objective To evaluate the GI and CV risk profile of patients with OA who require NSAIDs.

Methods A transversal, multicentre and observational study was conducted in consecutive patients with OA who were considered candidates for NSAID treatment and were visited by 374 unselected rheumatologists throughout the National Health System. Patients were classified into three risk groups (low, moderate and high) for their GI and CV characteristics. These were defined by considering the presence of a number of well-established GI risk factors or by application of the Systematic Coronary Risk Evaluation model for assessing the overall risk for CV disease, respectively.

Results Of 3293 consecutive patients, most (86.6%) were at increased GI risk and a considerable number, 22.3%, were at high GI risk. The CV risk was high in 44.2% of patients, moderate in 28.5% and low in 27.3%. Overall, 15.5% of patients presented a very high-risk profile, having high GI and CV risks. The type of NSAID prescription was similar regardless of the associated GI and CV risk profile.

Conclusion Most patients with OA requiring NSAIDs for pain control showed a high prevalence of GI and CV risk factors. Over half of the patients were at either high GI or CV risk, or both, such that the prescription of OA treatments should be very carefully considered.

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Footnotes

  • Funding Sponsored by Pfizer Spain Laboratories, Avenida de Europa 20-B, Parque Empresarial La Moraleja, 28108, Alcobendas, Madrid, Spain.

  • Competing interests AL is an advisor to Pfizer, AstraZeneca and Nicox and is member of steering committees of studies sponsored by Bayer (ARRIVE), AstraZeneca (ENERGIB) and Pfizer (CONDOR). JT and JLZ declare no conflicts of interest.

  • Ethics approval The work was presented to, and approved by, the Regional Ethics Committee for Clinical Research, Hospital San Carlos (Madrid).

  • Provenance and peer review Not commissioned; externally peer reviewed.

    The manuscript has been written by the authors and represents the interpretation of data by the authors of the study and not by Pfizer. The authors of this article have had full access to the data, which have been analysed based on predefined criteria and guided by the authors.

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