New users of low-dose aspirin have a significantly increased risk of developing gastric and duodenal ulcers
Treatment with low-dose acetylsalicylic acid is associated with a higher risk of gastric ulcer. Photo: Shutterstock.com.
This risk does not occur in “prevalent” users, as determined by the finding, cautioning the importance of weighing the risks and benefits of starting treatment with a low dose of aspirin.
Before this treatment, “careful weighing of the risks and benefits is recommended,” said Ben Schottker of the German Cancer Research Center in Heidelberg, Germany, and “once treatment is started, to ensure safe long-term Monitoring of adverse effects is recommended for use,” he said.
Although it has been shown that Acetylsalicylic acid in dosage less is a ulcer risk factors peptic ulcer, previous cohort studies may have underestimated the risk because the researchers did not employ a new user design, the researchers noted.
This is important because gastrointestinal bleeding occurs more frequently in low-dose treatment than in later years.
Schöttker et al evaluated the relationship between low-dose aspirin treatment and the development of gastric and duodenal ulcers in both current and new users.
In this study, “prevalent users” are people who were taking low-dose aspirin at the start of the study and were generally taking it for some time before study follow-up began.
Study data 7,737 . comes from german study participants “ESTHER” from UK Biobank and 213,598 with over ten years of follow-up.
Among popular users, low dose of acid Aspirin was not significantly associated with gastric ulcer in any of the cohorts. had a statistically weak association Vital with duodenal ulcer In UK Biobank – Relative Risk (HR): 1.27; 95% confidence interval [IC 95%]: 1.07 to 1.51- but not in “ESTHER” (HR: 1.33; 95% CI: 0.54 to 3.29).
Restricting the risk to new users only, the use of low-dose aspirin was significantly associated with a 1.8-fold risk. higher incidence of ulcers There was a 2.8-fold increased risk in the UK Biobank (HR: 1.82; 95% CI: 1.58 to 2.11) and “ASTER” (HR: 2.83; 95% CI: 1.40 to 5.71) in the multivariable model.
For duodenal ulcer in new users, the use of low-dose aspirin was associated with a 1.7-fold increased risk in the UK Biobank (HR: 1.66; 95% CI: 1.36 to 2,04) and with a 3.9-fold increased risk” ESTHER “” (HR: 3.89; 95% CI: 1.46 to 10.42).
These two large cohort studies suggest that low-dose aspirin use is a “strong and independent” risk factor for gastric and duodenal ulcers in new users of low-dose aspirin, but not in prevalent users.
The authors noted that people who took low doses of aspirin for years and had no digestive symptoms may tolerate the drug well.
“This is an important study,” said Dr. Ashwin Ananthakrishnan, MPH, gastroenterologist at Massachusetts General Hospital and Harvard Medical School in Boston, United States.
“Most of the literature on aspirin (or NSAIDs) and the risks of gastric/duodenal ulcers is for full-dose aspirin or its equivalent,” he explained, noting that less is known about the adverse effects or risks of low-dose aspirin. goes.
“Using two complementary data sources, this study showed that low dose of acid Aspirin is associated with an increased risk in new users (…), however, even if there is an increased risk, any potential increase will be judged against the benefits of low-dose aspirin for its other health effects, including cardio protection. must be weighed,” Dr Ananthakrishnan said.
“Furthermore, the fact that there was no association among prevalent users suggests that in people who have been taking low-dose aspirin for many years, without any gastric or duodenal ulcers, continued use is likely to be safe, It will be beneficial as long as it continues.” for other indications,” he concluded.