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Serious gastrointestinal effects of nonsteroidal anti-inflammatory drugs (NSAIDS) in a prospective study in Morocco Volume 15, issue 2, Mai-Juin 2005

Authors
Centre national de pharmacovigilance du Maroc, Rue Lemfedel Cherkaoui, Madinate al Irfane, BP 769, Rabat, Maroc, Service de la medecine C, Hôpital Ibn Sina, Rabat, Maroc, Service des urgences chirurgicales, Hôpital Ibn Sina, Rabat, Maroc

In Morocco, the need for post-marketing surveillance of selective Cox2 inhibitors (coxibs) prompted a study to assess the serious gastrointestinal effects of NSAIDs and to compare gastrointestinal tolerance of conventional NSAIDs and coxibs. A prospective study was conducted from April 2001 through May 2002 among hospital-staff gastroenterologists in the public and private sector as well as emergency surgical units. Over this period, 123 patients were reported to have serious NSAID-related gastrointestinal effects, and 63% of them were admitted for bleeding or perforated ulcers. Endoscopy most often identified the lesion as a gastric ulcer (45%). Emergency rooms reported that aspirin was the most common causal agent and that NSAIDs accounted for 8.7% of bleeding and 9.3% of the perforated ulcers. Our findings indicate that men and youth are most vulnerable to serious gastrointestinal effects from these drugs. Several risk factors from the literature were confirmed in our population: history of gastrointestinal disorders and joint disease, occurrence within less than 1 month of beginning the drug; association of NSAIDs and aspirin, diabetes and hypertension. No conclusion could be drawn about the comparative gastrointestinal tolerance of conventional NSAIDs and coxibs, however, since the latter account for only 3% of the NSAID market.