The risk of major upper gastrointestinal bleeding (UGIB) in relation to the use of drugs, particularly non-narcotic analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), will be evaluated in a case-control study. Cases will be patients admitted to hospital with first episodes of UGIB, without antecedent peptic ulcer disease, cirrhosis, alcoholism, or other predisposing conditions. Cases will be identified from hospitals in eastern Massachusetts. Neighbor controls of the same age and sex as the cases will be identified from town lists at a ratio of four per case. Study subjects will be interviewed at home by telephone to obtain information of analgesic and other drug use in the preceding six months, personal data and habits (e.g., marital status, cigarette smoking, alcohol consumption), and relevant medical history. For the cases, information on the symptoms and clinical course of their illness will also be obtained. It is expected that at least 600 cases and 2400 controls will be studied. The data will be used to quantify associations between individual analgesics or NSAIDs and UGIB, and to compare the relative effects of the different drugs. Absolute risks attributable to specific drugs will be calculated after deriving an estimate of the incidence of UGIB from data provided by the Massachusetts Health Data Consortium. Finally, the relation of UGIB to the use of non-analgesic drugs and other factors (e.g., cigarette smoking) will be investigated.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK036997-03
Application #
3235620
Study Section
Epidemiology and Disease Control Subcommittee 3 (EDC)
Project Start
1987-01-05
Project End
1990-12-31
Budget Start
1989-01-01
Budget End
1989-12-31
Support Year
3
Fiscal Year
1989
Total Cost
Indirect Cost
Name
Boston University
Department
Type
Schools of Medicine
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Kaufman, D W; Kelly, J P; Wiholm, B E et al. (1999) The risk of acute major upper gastrointestinal bleeding among users of aspirin and ibuprofen at various levels of alcohol consumption. Am J Gastroenterol 94:3189-96
Kelly, J P; Laszlo, A; Kaufman, D W et al. (1999) Major upper gastrointestinal bleeding and the use of calcium channel blockers. Lancet 353:559
Laszlo, A; Kelly, J P; Kaufman, D E et al. (1998) Clinical aspects of upper gastrointestinal bleeding associated with the use of nonsteroidal antiinflammatory drugs. Am J Gastroenterol 93:721-5
Kelly, J P; Kaufman, D W; Jurgelon, J M et al. (1996) Risk of aspirin-associated major upper-gastrointestinal bleeding with enteric-coated or buffered product. Lancet 348:1413-6
Kelly, J P; Kaufman, D W; Koff, R S et al. (1995) Alcohol consumption and the risk of major upper gastrointestinal bleeding. Am J Gastroenterol 90:1058-64
Kaufman, D W; Kelly, J P; Sheehan, J E et al. (1993) Nonsteroidal anti-inflammatory drug use in relation to major upper gastrointestinal bleeding. Clin Pharmacol Ther 53:485-94