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In randomized trials, proton-pump inhibitors (PPIs) have lowered risk for upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs. Because older age is a risk factor for such complications, researchers used Veterans Affairs and Medicare databases to examine outcomes of NSAID and PPI prescribing among older U.S. veterans (age, ≥65) in this retrospective study.
From 2000 through 2002, more than 480,000 veterans (mean age, 74) received traditional NSAIDs other than low-dose aspirin or cyclooxygenase-2 inhibitors (coxibs). The median duration of exposure was 4 months. Eighty percent of patients received NSAIDs alone; 11% received NSAIDs plus PPIs; the rest received coxibs with or without PPIs. In a multivariate …