Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis

Derry, Sheena and Loke, Yoon Kong (2000) Risk of gastrointestinal haemorrhage with long term use of aspirin: meta-analysis. BMJ, 321 (7270). pp. 1183-1187. ISSN 0959-8138

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Abstract

Objectives: To assess the incidence of gastrointestinal haemorrhage associated with long term aspirin therapy and to determine the effect of dose reduction and formulation on the incidence of such haemorrhage. Design: Meta-analysis of 24 randomised controlled trials (almost 66 000 participants). Intervention: Aspirin compared with placebo or no treatment, for a minimum of one year. Main outcome measures: Incidence of gastrointestinal haemorrhage. Results: Gastrointestinal haemorrhage occurred in 2.47% of patients taking aspirin compared with 1.42% taking placebo (odds ratio 1.68; 95% confidence interval 1.51 to 1.88); the number needed to harm was 106 (82 to 140) based on an average of 28 months' therapy. At doses below 163 mg/day, gastrointestinal haemorrhage occurred in 2.30% of patients taking aspirin compared with 1.45% taking placebo (1.59; 1.40 to 1.81). Meta-regression showed no relation between gastrointestinal haemorrhage and dose. For modified release formulations of aspirin the odds ratio was 1.93 (1.15 to 3.23). Conclusions: Long term therapy with aspirin is associated with a significant increase in the incidence of gastrointestinal haemorrhage. No evidence exists that reducing the dose or using modified release formulations would reduce the incidence of gastrointestinal haemorrhage.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: EPrints Services
Date Deposited: 25 Nov 2010 11:12
Last Modified: 04 Mar 2024 16:47
URI: https://ueaeprints.uea.ac.uk/id/eprint/14788
DOI: 10.1136/bmj.321.7270.1183

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