Aims: To examine whether the risk of some selected adverse effects increases with the number of systemic non-steroidal anti-inflammatory (NSAID) drugs.
Methods: The French Pharmacovigilance database was examined for an association between drug reaction reports and the exposure to one and two or more NSAIDs using a case/non-case study design. In the analysis, 54,583 spontaneous reports of adverse drug reactions were included, consisting of 2270 reports of hepatic injury, 994 reports of acute renal failure, 194 reports of gastrointestinal bleeding and 525 reports of angioedema, among others.
Results: Use of NSAIDs significantly increased the risk of hepatic injury, gastrointestinal bleeding, acute renal failure and angioedema. The odds ratios tended to increase with the number of NSAIDs for hepatic injury, gastrointestinal bleeding and acute renal failure but not for angioedema. In comparison with reports that did not mention any use of NSAIDs, the odds ratios associated with the use of a single NSAID and two or more NSAIDs were respectively 1.2 (95%CI: 0.9-1.5) and 2.2 (95%CI: 1.3-3.8) for hepatic injury, 7.3 (95%CI: 4.9-10.9) and 10.7 (95%CI: 2.9-40.2) for gastrointestinal bleeding, 3.2 (95%CI: 2.5-4.1) and 4.8 (95%CI: 2.6-8.8) for acute renal failure. For angioedema, the odds ratios were roughly similar when a single NSAID (OR=2.7; 95% CI: 2.2-3.4) or two or more NSAIDs (OR=2.0; 95%CI: 0.7-6.0) were used. The risk of severe ADRs (hepatic injury and acute renal failure) was six- to sevenfold higher in reports mentioning concomitant use of two NSAIDs or more than in those that did not.
Conclusion: This study shows that concomitant use of two or more NSAIDs was associated with an excess risk of adverse effects such as hepatic injury, acute renal failure and gastrointestinal bleeding. Although simultaneous use of several systemic NSAIDs has no pharmacological justification, this may raise a serious public health problem with the increasing use of over-the-counter non-steroidal anti-inflammatory agents.
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http://dx.doi.org/10.1007/s00228-004-0761-0 | DOI Listing |
Ecotoxicol Environ Saf
January 2025
West China Center of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; Regenerative Medicine Research Center, Sichuan University West China Hospital, Chengdu, Sichuan 610041, China. Electronic address:
Dichlorvos (DDVP) is an organophosphorus pesticide commonly utilized in agricultural production. Recent epidemiological studies suggest that exposure to DDVP correlates with an increased incidence of liver disease. However, data regarding the hepatotoxicity of DDVP remain limited.
View Article and Find Full Text PDFMetab Brain Dis
January 2025
Institute of Liver and Biliary Sciences, New Delhi, India.
Hepatic encephalopathy (HE) is traditionally associated with hepatic parenchymal diseases, such as acute liver failure and cirrhosis. Its prevalence in non-cirrhotic portal hypertension (NCPH) patients, extrahepatic portal vein obstruction (EHPVO), and non-cirrhotic portal fibrosis (NCPF) is less well described. HE in NCPH allows one to study the effect of portosystemic shunting and ammonia without significant hepatic parenchymal injury.
View Article and Find Full Text PDFChin Med J (Engl)
January 2025
Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Department of Minimal Invasive Hepatic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China.
Background: Arsenic trioxide (ATO) is indicated as a broad-spectrum medicine for a variety of diseases, including cancer and cardiac disease. While the role of ATO in hepatic ischemia/reperfusion injury (HIRI) has not been reported. Thus, the purpose of this study was to identify the effects of ATO on HIRI.
View Article and Find Full Text PDFJ Occup Med Toxicol
January 2025
Carrera de Medicina, Universidad Continental, Huancayo, 12000, Peru.
Introduction: Chronic exposure to pesticides causes various adverse health effects, mainly at a neurological level. However, there is little evidence focused on liver tissue injury and transaminase activity as indicators of effect.
Methods: A cross-sectional study was designed based on medical-occupational records of workers from an agro-export company in Peru to associate the levels of butyrylcholinesterase (BChE) transaminases (ALT and AST).
Immunopharmacol Immunotoxicol
January 2025
Department of Medical Oncology, The First Affiliated Hospital of Zhejiang University School of Medicine, 310003 Hangzhou, China.
Background: The incidence of hepatic immune-related adverse events has increased with the wide use of immune checkpoint inhibitors, some immune-mediated hepatotoxicity cases are severe and lack of clinical recommendations.
Objective: This study aimed to evaluate the efficacy of artificial liver support systems (ALSS) in the treatment of immune-mediated hepatotoxicity.
Methods: This retrospective case series included six patients with grade 4 hepatotoxicity with high bilirubin induced by immune checkpoint inhibitors treated between January 1, 2019, to December 31, 2021.
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