|NSAIDS Increase Risk of Hospitalization for Acute Hepatitis|
|Written by Roman Bystrianyk|
|Sunday, 17 October 2010 19:53|
In an investigative article from earlier this year it was estimated that the total number of people in the United States hospitalized due to NSAID bleeding at 1.7 million was higher than the total of all American casualties from all American wars combined. Now a new study adds the risk hospitalization due to acute hepatitis for NSAID users.
Nonsteroidal anti-inflammatory drugs, or NSAIDS, are a class of medication often believed to be well tolerated and are commonly used as a therapy for common inflammation. Everyone is familiar with these types of drugs with millions using them for pain relief. NSAIDs include: ibuprofen (Advil®), naproxen (Aleve®), and aspirin (Bayer®). Perscription brands include: celecoxib (Celebrex®), diclofenac (Voltaren®), etodolac (Lodine®), fenoprefen (Nalfon®), indomethacin (Indocin®), ketoprofen (Orudis®, Oruvail®), ketoralac (Toradol®), oxaprozin (Daypro®), nabumetone (Relafen®), sulindac (Clinoril®), tolmetin (Tolectin®), and rofecoxib (Vioxx®).
In the first pharmacoepidemiology study using case-crossover design of a database of liver toxicity in the real world authors publishing in Pharmacoepidemiology and Drug Safety examined the potential risk of hospitalization due to acute hepatitis (liver inflammation) among NSAID users. The authors examined patients hospitalized with a major diagnosis of acute or sub-acute necrosis (premature death of living tissue) of the liver or toxic hepatitis using the National Health Insurance database in Taiwan.
"Drug-induced liver injury (DILI) is a common cause of acute non-viral nontoxic liver failure, and liver damage is a major reason for withdrawal of a drug from the market. In France, the incidence rate of outpatient DILI amount to fourteen cases per 100,000 inhabitants, which is still considered as an underestimation because of the difficulty in diagnosis."
Their study found that various hepatoxic (toxic to the liver) NSAIDs increased the risk of hospitalization for acute hepatitis which confirms previous studies. However, the authors note that because they only were detecting severe cases that resulted in hospitalizations their study no doubt resulted in an underestimation of the hepatoxicity of NSAIDs.
The authors conclude that "our results also corroborate the evidence that the risk of hospitalization for hepatopathy among users of nimesulide was higher than for those using other hepatoxic NSAIDs. On the other hand, there seemed to be a slightly higher toxicity for celecoxib (Celebrex®) in our study compared to those conducted in Western countries. Our results provide additional safety information for the use of celecoxib as well as hepatoxic NSAIDs, with the finding that there was an increased risk of hospitalization for acute hepatitis. Further mechanistic research is warranted for celecoxib's hepatoxicity."
Increased risk of hospitalization for acute hepatitis in patients with previous exposure to NSAIDs, Pharmacoepidemiology and Drug Safety, 2010
|Last Updated on Sunday, 17 October 2010 20:01|