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NSAID, acetaminophen use linked to higher risk for active disease in Crohn’s patients
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SAN DIEGO — Crohn’s disease patients who reported using nonsteroidal anti-inflammatory drugs more than once per week demonstrated a significantly higher risk for active disease compared with those who used them less often, a speaker said here.
Acetaminophen use also was associated with greater risk for exacerbated Crohn’s disease (CD), Millie D. Long MD, MPH, assistant professor of medicine, gastroenterology and hepatology division at University of North Carolina, said at the American College of Gastroenterology Annual Scientific Meeting. Ulcerative colitis (UC) patients demonstrated no increased risk for active disease from NSAID or acetaminophen use, she said.
Researchers used bivariate statistics and binomial regression models to determine the independent effects of NSAIDs and acetaminophen use on flare-ups among 711 patients with inflammatory bowel disease. All patients, 519 with CD and 192 with UC, were in disease remission.
Patients’ patterns of NSAID and acetaminophen use were determined at study initiation, and disease activity was assessed 6 months later.
Within the CD population, 23% of patients who used NSAIDs at least 5 times per month had a flare-up, compared with 15% of patients who reported using NSAIDs fewer than 5 times per month (P=.04). Among subjects who used any acetaminophen, 20% reported flare ups, compared with 11% of patients who did not (P=.01).
Any use of NSAID vs. nonuse of NSAID did not present statistically significant results in CD patients, Long said.
Among UC patients, there were no instances of statistically significant differences: any NSAID use vs. nonuse resulted in 24% flare-ups to 20%; NSAID use more than 5 times per month resulted in 22% flare-ups, compared with 21% among those who used NSAIDs fewer than 5 times monthly. Any acetaminophen vs. no acetaminophen use resulted in 22% vs. 20% of flare-ups, respectively, said Long, who added that the study was limited by its short length and lack of objective measures of inflammation.
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Long MD. #26: Role of Nonsteroidal Anti-inflammatory Drugs in Exacerbations of Inflammatory Bowel Disease. Presented at: the 2013 American College of Gastroenterology Annual Scientific Meeting; Oct. 11-16, San Diego.