Department of Internal Medicine, CHI Health Creighton University Medical Center-Bergan Mercy, 7710 Mercy Rd, Suite 301, Omaha, NE, 68124, USA.
Department of Clinical Research and Public Health, Creighton University School of Medicine, CHI Health Creighton University Medical Center-Bergan Mercy, 7710 Mercy Rd, Suite 502, Omaha, NE, 68124, USA.
Sci Rep. 2022 Aug 24;12(1):14452. doi: 10.1038/s41598-022-18654-2.
The use of selective serotonin reuptake inhibitors (SSRIs) can increase the risk of gastrointestinal (GI) bleeding. Similarly, it is well known that the use of NSAIDs predisposes patients to upper GI bleeding. The aim of this study was to explore if the addition of SSRIs in patients already taking NSAIDs significantly increases their risk for upper GI bleeding. An electronic literature search was conducted using the SCOPUS and MEDLINE databases from inception through September 2020. Cohort and case-control trials that reported patients with upper GI bleeding on NSAIDs with SSRIs, compared to controls on NSAIDs only were included. Newcastle-Ottawa checklist was used to ensure inclusion of high-quality studies. Data was extracted by the lead investigator and cross-checked by the second author. Dichotomous data was pooled to obtain an odds ratio (OR) of the risk of upper GI bleeding in patients on NSAIDs with concomitant SSRI use. The primary endpoint of the study was the risk of upper GI bleeding with SSRIs and NSAIDs compared to NSAIDs alone. A total of 366 citations were reviewed, and 21 were selected for full-text evaluation. 1 cohort and 9 case-control studies were eligible. There was an additional increased risk of upper GI bleeding in patients on NSAIDs with concomitant SSRI use (OR 1.75, 95% CI = 1.32-2.33). In patients already on NSAID therapy, the concomitant use of SSRIs can significantly increase the risk of upper of GI bleeding.
选择性 5-羟色胺再摄取抑制剂(SSRIs)的使用会增加胃肠道(GI)出血的风险。同样,众所周知,非甾体抗炎药(NSAIDs)的使用会使患者更容易发生上消化道出血。本研究旨在探讨 NSAIDs 治疗患者中 SSRIs 的添加是否会显著增加上消化道出血的风险。使用 SCOPUS 和 MEDLINE 数据库进行了电子文献检索,检索时间从建库到 2020 年 9 月。纳入了报告 NSAIDs 治疗患者中上消化道出血且同时使用 SSRIs 的队列和病例对照研究,与仅使用 NSAIDs 的对照组进行比较。使用纽卡斯尔-渥太华量表来确保纳入高质量的研究。主要研究者提取数据,由第二作者进行交叉核对。对二分类数据进行汇总,以获得 NSAIDs 联合 SSRIs 治疗患者上消化道出血风险的比值比(OR)。本研究的主要终点是 NSAIDs 联合 SSRIs 与 NSAIDs 单独治疗相比上消化道出血的风险。共审查了 366 条引文,其中 21 条被选作全文评估。1 项队列研究和 9 项病例对照研究符合入选标准。与 NSAIDs 单独治疗相比,NSAIDs 联合 SSRIs 治疗的患者上消化道出血风险增加(OR 1.75,95%CI=1.32-2.33)。在已经接受 NSAID 治疗的患者中,SSRIs 的同时使用会显著增加上消化道出血的风险。