Effect of Aspirin on NSAID-Associated Ulcer Bleeding

Using low-dose aspirin concomitantly with coxibs negates coxibs’ benefit for lower bleeding risk.

Use of nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk for peptic ulcers and gastrointestinal bleeding. Selective cyclooxygenase-2 inhibitors (coxibs) confer lower risk for these complications. However, concomitant use of aspirin irreversibly and nonselectively inactivates the cyclooxygenase enzymes. Some data suggest that cotherapy with aspirin eliminates any benefit on bleeding risk that is imparted by coxibs.

To evaluate this issue, investigators performed a partially industry-supported case-control analysis. Cases were 2777 consecutive patients in the General Health System of Spain with endoscopy-proven upper gastrointestinal bleeding (UGIB) from peptic ulcers; 5532 age-matched patients without gastrointestinal …

Reviewing Author

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)