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aspirin and gastrointestinal bleeding

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7661. Enteric-coated pelletized aspirin. Gastrointestinal blood loss and bioavailability. (Abstract)

Enteric-coated pelletized aspirin. Gastrointestinal blood loss and bioavailability. Eleven patients suffering from arthritis received, in a randomized cross-over study, anti-inflammatory doses of two aspirin formulations: Enpryn, capsules containing enteric-coated pellets; Rhusal, an enteric-coated tablet. No significant difference was found between the two formulations with respect to gastrointestinal microbleeding, plasma salicylate levels and urinary recovery of salicylate. Bioavailability

1981 The Medical journal of Australia Controlled trial quality: uncertain

7662. Gastrointestinal blood loss of oxaprozin and aspirin with placebo control. (Abstract)

Gastrointestinal blood loss of oxaprozin and aspirin with placebo control. The objective of this study was to compare the effects of oxaprozin (4,5-diphenyl-2-oxazolepropionic acid), a nonsteroidal, antiinflammatory compound, and aspirin in a double-blind, placebo-controlled study to estimate gastrointestinal bleeding. The determination of fecal blood loss was made quantitatively by the use of the radioactive (51Cr) technique. During the first week, subjects were controlled with and without (...) the active treatment period, weeks 3 and 4, there were statistically significant differences among the three groups. The mean blood loss during week 3 was significantly greater for the aspirin group, 8.8 ml/day, than the oxaprozin group, 3.3 ml/day (P less than 0.05), and the placebo group, 1.4 ml/day (P less than 0.001). The smaller difference between oxaprozin and placebo was also significant (P less than 0.05). During the fourth week, the mean daily blood loss among oxaprozin patients had decreased

1982 Journal of clinical pharmacology Controlled trial quality: uncertain

7663. Comparative gastrointestinal blood loss associated with placebo, aspirin, and nabumetone as assessed by radiochromium (51Cr). (Abstract)

(acetylsalicylic acid, ASA), and placebo in a double blind parallel study using chromium 51Cr labelled red cells to quantitate fecal blood loss (FBL) in healthy volunteers. Thirty subjects were randomized to treatment with nabumetone (2000 mg), ASA (3.6 g) or placebo for 21 days following a 7 day placebo period. Six subjects served as untreated controls. FBL in nabumetone treated subjects was not significantly different to placebo or untreated subjects. In contrast, ASA-treated subjects exhibited significantly (...) Comparative gastrointestinal blood loss associated with placebo, aspirin, and nabumetone as assessed by radiochromium (51Cr). Nabumetone differs from most other nonsteroidal anti-inflammatory drugs. It is presented to the gut as a nonacidic prodrug, and is metabolized to its active form after absorption. Studies in animals and humans suggest it is less irritating to the gastrointestinal mucosa. This study compared the gastrointestinal microbleeding induced by nabumetone to aspirin

1989 Journal of clinical pharmacology Controlled trial quality: uncertain

7664. Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin

@tripdatabase.com Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin/warfarin? We searched the NLH Specialist Libraries for Cardiovascular Diseases, Gastroenterology and Liver Diseases as well as the TRIP and Medline databases but found no guidelines or studies examining the effectiveness of proton pump inhibitors to reduce gastrointestinal side-effects (...) Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin Is there good evidence for reducing gastro-intestinal side-effects including bleeding by adding a PPI in those patients on dual anti-thrombotic rx eg aspirin/clopidogrel, aspirin/dipyrimadole, aspirin/warfarin? - Trip Database or use your Google+ account Find evidence fast ALL of these words

2007 TRIP Answers

7665. What is the incidence of GI bleeding from low dose aspirin (75mg od) in various age groups and what is the incidence of GI bleeding with ibuprofen 400mg tds in the same groups?

aspirin (75mg od) in various age groups and what is the incidence of GI bleeding with ibuprofen 400mg tds in the same groups? To answer this question we searched the following sources: the NLH Later Life Specialist Library, the TRIP and Medline databases, the Oxford Pain Internet Site (Bandolier) and the aspirin and ibuprofen foundations. We found no studies indicating the incidence or odds ratio of suffering gastrointestinal bleeding on low dose aspirin (75mg) by age categories. However, we located (...) in prescribing of proton pump inhibitors and selective serotonin reuptake inhibitors, and also in the 75 mg dose of aspirin (Figure 2). NSAID prescribing did not change over the period.” [1] Concerning ibuprofen, we found no studies examining the incidence of GI bleeding by age group. References 1. Bandolier. Low dose aspirin and haemorrhage in older people. ( ) Answered 27 February 2008 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2008 TRIP Answers

7666. Is enteric coated aspirin less likely to cause gastrointestinal (GI) bleeding than dispersible aspirin?

Is enteric coated aspirin less likely to cause gastrointestinal (GI) bleeding than dispersible aspirin? Is enteric coated aspirin less likely to cause gastrointestinal (GI) bleeding than dispersible aspirin? - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document (...) across other content types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com Is enteric coated aspirin less likely to cause gastrointestinal (GI) bleeding than dispersible aspirin? ATTRACT found no information directly comparing enteric coated aspirin with soluble aspirin

2004 TRIP Answers

7667. A risk score to predict silent myocardial ischemia in patients with coronary artery disease under aspirin therapy presenting with upper gastrointestinal hemorrhage. (Abstract)

A risk score to predict silent myocardial ischemia in patients with coronary artery disease under aspirin therapy presenting with upper gastrointestinal hemorrhage. Silent myocardial ischemia (SMI) is a relatively common complication in patients with coronary artery disease (CAD) under aspirin therapy presenting with upper gastrointestinal hemorrhage (UGIH).This study was conducted to develop and prospectively validate a risk prediction score to identify SMI in patients undergoing aspirin (...) therapy for CAD presenting with UGIH in the emergency department (ED).This was a 2-phase noninterventional study. In the derivation phase, adults with CAD under aspirin therapy (100 mg once daily) presenting to the ED with UGIH were retrospectively recruited. By multiple logistic regression analysis, we derived a risk score from 224 patients that predicts the patients' risk of SMI. In the validation phase, we prospectively validated this score using receiver operating characteristic curves with data

2007 American Journal of Emergency Medicine

7668. Effect of nabumetone and aspirin on colonic mucosal bleeding time. (Abstract)

Effect of nabumetone and aspirin on colonic mucosal bleeding time. The management of patients taking aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) who require colonoscopy remains controversial because of concerns over bleeding after biopsy or polypectomy.To determine whether patients using the NSAID nabumetone, a non-acidic prodrug with mixed activity against cyclooxygenase-1 (COX-1) and COX-2, exhibited prolonged mucosal bleeding times and how this might compare with mucosal (...) bleeding times in patients using aspirin.We assessed triplicate mucosal bleeding times in patients undergoing screening flexible sigmoidoscopy. We compared 90 patients who had taken no aspirin or NSAIDs within the previous 2 weeks, to 60 patients who had received nabumetone 1 g b.d. by mouth for the previous 2 weeks, and 30 patients who had taken 325 mg aspirin daily for the previous 2 weeks. In each case, the investigator performing the study was blinded to the patient's medication.Mucosal bleeding

2001 Alimentary pharmacology & therapeutics Controlled trial quality: uncertain

7669. [Therapeutic and prophylactic role of mesalazine (5-ASA) in symptomatic diverticular disease of the large intestine. 4 year follow-up results]. (Abstract)

[Therapeutic and prophylactic role of mesalazine (5-ASA) in symptomatic diverticular disease of the large intestine. 4 year follow-up results]. In order to evaluate the efficacy and tolerability of mesalazine (5-ASA) in the prophylaxis of symptomatic relapses, of major complications and of microhemorrhagic phenomena in diverticular disease of the large intestine (MDC), prospective clinical study was conducted on patients with light-moderate symptomatic MDC under treatment with sulbactam (...) -up, 44 patients dropped out of the study (9 because of major complications, 3 for massive hemorrhage, and 32 drop outs). Symptomatic relapses occurred in 51 patients (12 M; 39 C), while minor diverticular hemorrhages occurred in 43 patients (12 M; 31 C), with an estimated probability of remaining free respectively from symptomatic relapse (p=0.00005) and from microhemorrhagic phenomena (p=0.001) decisively in favor of the group treated with mesalazine. The duration of abdominal pain due

2006 Minerva gastroenterologica e dietologica Controlled trial quality: uncertain

7670. A double blind randomized placebo-controlled study demonstrates the protective efficacy of rosaprostol on aspirin-induced gastrointestinal bleeding in man. (Abstract)

Medica Generale, Universita' di Torino, Italy. Babini G G Arduino C C Lanzio M M Anfossi G G Ciani D D Emanuelli G G eng Clinical Trial Journal Article Randomized Controlled Trial United States Adv Prostaglandin Thromboxane Leukot Res 8211444 0732-8141 0 Anti-Ulcer Agents 0 Prostanoic Acids R16CO5Y76E Aspirin W4459A2P0J rosaprostol IM Adult Anti-Ulcer Agents therapeutic use Aspirin antagonists & inhibitors Double-Blind Method Gastrointestinal Hemorrhage chemically induced prevention & control Humans (...) A double blind randomized placebo-controlled study demonstrates the protective efficacy of rosaprostol on aspirin-induced gastrointestinal bleeding in man. 1825412 1991 03 28 2013 11 21 0732-8141 21B 1991 Advances in prostaglandin, thromboxane, and leukotriene research Adv. Prostaglandin Thromboxane Leukot. Res. A double blind randomized placebo-controlled study demonstrates the protective efficacy of rosaprostol on aspirin-induced gastrointestinal bleeding in man. 789-92 Calcamuggi G G Clinica

1991 Advances in prostaglandin, thromboxane, and leukotriene research Controlled trial quality: uncertain

7671. Risk of major gastrointestinal bleeding with aspirin. (Abstract)

Risk of major gastrointestinal bleeding with aspirin. 10023923 1999 03 04 2015 06 16 0140-6736 353 9147 1999 Jan 09 Lancet (London, England) Lancet Risk of major gastrointestinal bleeding with aspirin. 148-50 Isles C C Norrie J J Paterson J J Ritchie L L eng Clinical Trial Comment Letter Randomized Controlled Trial England Lancet 2985213R 0140-6736 0 Anti-Inflammatory Agents, Non-Steroidal 0 Delayed-Action Preparations R16CO5Y76E Aspirin AIM IM Lancet. 1998 Jan 24;351(9098):233-41 9457092 (...) Lancet. 1998 Jun 13;351(9118):1755-62 9635947 Lancet. 1999 Feb 20;353(9153):676 10030365 Lancet. 1999 Feb 20;353(9153):676 10030366 Aged Anti-Inflammatory Agents, Non-Steroidal administration & dosage adverse effects Aspirin administration & dosage adverse effects Cerebrovascular Disorders prevention & control Delayed-Action Preparations Gastrointestinal Hemorrhage chemically induced Humans Middle Aged Myocardial Infarction prevention & control Risk 1999 2 19 1999 2 19 0 1 1999 2 19 0 0 ppublish

1999 Lancet (London, England) Controlled trial quality: uncertain

7672. Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events. A critical analysis. (Abstract)

Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events. A critical analysis. Low-dose aspirin has been recommended for primary and secondary prevention of myocardial infarction and for the maintenance of aortocoronary bypass patency. Doses as low as 75 mg/day significantly lessen the risk of stroke or death in patients who experience cerebrovascular and ischemic events. Aspirin in antiinflammatory doses has been associated (...) with gastrointestinal bleeding, and the bleeding potential of even 75 mg aspirin has been established. I assessed the role of low-dose aspirin in gastrointestinal bleeding by combining the results of nine studies that dealt with the prevention of ischemic, thromboembolic, or cerebrovascular events. The combination of the results showed that the occurrence of bleeding was 1.5 times higher in patients treated with low-dose aspirin in doses of 75-325 mg/day as compared with placebo (odds ratio 1.52; 95% CI 1.32-1.75

1995 Journal of clinical gastroenterology

7673. Risk of upper gastrointestinal bleeding and perforation associated with low-dose aspirin as plain and enteric-coated formulations. Full Text available with Trip Pro

Risk of upper gastrointestinal bleeding and perforation associated with low-dose aspirin as plain and enteric-coated formulations. The use of low-dose aspirin has been reported to be associated with an increased risk of upper gastrointestinal complications (UGIC). The coating of aspirin has been proposed as an approach to reduce such a risk. To test this hypothesis, we carried out a population based case-control study.We identified incident cases of UGIC (bleeding or perforation) aged 40 to 79 (...) years between April 1993 to October 1998 registered in the General Practice Research Database. Controls were selected randomly from the source population. Adjusted estimates of relative risk (RR) associated with current use of aspirin as compared to non use were computed using unconditional logistic regression.We identified 2,105 cases of UGIC and selected 11,500 controls. Among them, 287 (13.6%) cases and 837 (7.3%) controls were exposed to aspirin, resulting in an adjusted RR of 2.0 (1.7-2.3

2001 BMC clinical pharmacology Controlled trial quality: uncertain

7674. Relation of upper gastrointestinal bleeding to non-steroidal anti-inflammatory drugs and aspirin: a case-control study. Full Text available with Trip Pro

Relation of upper gastrointestinal bleeding to non-steroidal anti-inflammatory drugs and aspirin: a case-control study. We conducted a case-control study in five general hospitals in the region of Antwerp, studying 161 patients (102 men, 59 women) and hospital control subjects matched for age and sex to explore the relation between drug use and upper gastrointestinal bleeding from 'erosive lesions' (peptic oesophagitis, gastric erosions, gastric ulcer(s), or duodenal ulcer(s (...) ]. There was a highly significant difference between cases and control subjects in the use of non-steroidal anti-inflammatory drugs (NSAIDs, excluding aspirin) (odds ratio 7.4, p less than 0.001; 95% confidence interval odds ratio 3.7 to 14.7). There also was a significant difference in the use of aspirin (odds ratio 2.2, p = 0.025; 95% CI odds ratio 1.3 to 4.0) and a highly significant difference regarding the presence of antecedents of peptic ulcer disease (odds ratio 5.5, p less than 0.001; 95% CI odds ratio 3.2

1991 Gut

7675. [Dose-dependent side effects of acetylsalicylic acid therapy. Results of a prospective randomized clinical study in patients with peripheral arterial occlusive disease]. (Abstract)

[Dose-dependent side effects of acetylsalicylic acid therapy. Results of a prospective randomized clinical study in patients with peripheral arterial occlusive disease]. In 359 patients with peripheral arterial occlusive disease who had undergone percutaneous transluminal angioplasty (PTA), a randomized double-blind, controlled clinical study was done to investigate the tolerability of acetyl salicylic acid (ASA) given for reocclusion prophylaxis. A comparison was made between a conventional (...) daily dose of 900 mg ASA and a dose of 50 mg ASA.Within an observation period of one year following PTA, 35 patients (20%) in the 900 mg group, and 32 patients (17%) in the 50 mg group left the trial because of side effects (p = NS). Under the higher dose, however, severe gastrointestinal side effects (ulcer, haemorrhagic gastritis requiring transfusion) were significantly more common (nine patients delta 5.1% vs two patients delta 1.1%, respectively; p = 0.03). Overall, 107 patients (30%) reported

1993 Medizinische Klinik (Munich, Germany : 1983) Controlled trial quality: uncertain

7676. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. (Abstract)

European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. In 1988, we undertook a randomized, placebo-controlled, double-blind trial to investigate the safety and efficacy of low-dose acetylsalicylic acid (ASA), modified-release dipyridamole, and the two agents in combination for secondary prevention of ischemic stroke. Patients with prior stroke or transient ischemic attack (TIA) were randomized to treatment with ASA alone (50 mg daily (...) < 0.001) and dipyridamole (p < 0.01) for preventing TIA. The risk reduction for the combination was 36% (p < 0.001) in comparison with placebo. Headache was the most common adverse event, occurring more frequently in dipyridamole-treated patients. All-site bleeding and gastrointestinal bleeding were significantly more common in patients who received ASA in comparison to placebo or dipyridamole. We conclude that (1) ASA 25 mg twice daily and dipyridamole, in a modified-release form, at a dose of 200 mg

1996 Journal of the neurological sciences Controlled trial quality: predicted high

7677. Failure of combined acetylsalicylic acid and dipyridamole to prevent occlusion of aortocoronary venous bypass graft. (Abstract)

Failure of combined acetylsalicylic acid and dipyridamole to prevent occlusion of aortocoronary venous bypass graft. Patients scheduled to receive at least three aortocoronary venous bypass grafts were randomized to active medication or to placebo. The former were given dipyridamole (DP) preoperatively and acetylsalicylic acid (ASA) was added after the operation. For the next 3 months they received DP 75 mg and ASA 325 mg thrice daily. The placebo regimen was identical and the study (...) was conducted with double-blind technique. One patient in each group died. DP-ASA was discontinued in six patients because of gastrointestinal side effects (bleeding peptic ulcer in 2 cases). Angiography after 3 months revealed the patency rate of individual grafts to be 68% in the DP-ASA group and 77% in the placebo group. DP-ASA therefore did not prevent occlusion of aortocoronary venous bypass grafts.

1987 Scandinavian journal of thoracic and cardiovascular surgery Controlled trial quality: uncertain

7678. [Stomach tolerance of acetylsalicylic acid by addition of calcium carbonate. A study of a 2-treatment/3-period cross-over design]. (Abstract)

[Stomach tolerance of acetylsalicylic acid by addition of calcium carbonate. A study of a 2-treatment/3-period cross-over design]. 18 male volunteers (age 24 +/- 4 years; Broca index 0.94 +/- 0.08; mean +/- SD) underwent six upper endoscopies (three control and three test investigations) in a single blind two treatments-crossover designed study which evaluated the effect of buffering on aspirin-induced (one single oral dose of 0.5 g aspirin to fasted subjects) gastroduodenal mucosal injury. All (...) volunteers experienced no gastrointestinal side effects. Three complained short-lasting gastric burning (two of group A, one of group B). In both treatment groups no significant lesions of the duodenum were found. Buffering significantly (p less than 0.0005) reduced mucosal injuries which occurred mainly as submucosal hemorrhage but without histological alterations of the mucosal architecture after aspirin ingestion. These findings suggest that oral administration of calcium carbonate buffered, chewable

1989 Medizinische Klinik (Munich, Germany : 1983) Controlled trial quality: uncertain

7679. Omeprazole in Peptic Ulcer Bleeding: IV PPI for GI bleeds

on bleeding recurrence after endoscopic treatment? Bottom Line This trial demonstrated a 70% reduction in rebleeding with intravenous omeprazole in patients with active GIB. Major Points Proton pump inhibitors (PPIs) have long been the mainstays of gastric acid suppression and stood as a staple in the management of GI hemorrhage. This study sought to investigate the efficacy of the intravenous PPI omeprazole in reducing rebleeding risk among patients with endoscopically-defined active GI hemorrhage (...) . It enrolled 240 predominantly male patients with GI hemorrhage who underwent early EGD demonstrating actively bleeding ulcer or nonbleeding ulcer with visible vessel, and randomized to intravenous omepraozle or placebo. Omeprazole reduced the 30-day risk of rebleeding by 70% compared with placebo; it also reduced the need for blood transfusion and was associated with a shorter hospitalization. Design Single center, double-blinded, parallel-group, randomized, placebo-controlled trial N=240 Omeprazole (n

2000 Wiki Journal Club

7680. Upper gastrointestinal haemorrhage associated with low-dose aspirin and anti-thrombotic drugs - a 6-year analysis and comparison with non-steroidal anti-inflammatory drugs. Full Text available with Trip Pro

Upper gastrointestinal haemorrhage associated with low-dose aspirin and anti-thrombotic drugs - a 6-year analysis and comparison with non-steroidal anti-inflammatory drugs. Low-dose aspirin and other anti-thrombotic therapy has been increasingly used for vascular protection.To assess the possibility that the incidence of upper gastrointestinal blood loss has changed in subjects using these agents in comparison with non-steroidal anti-inflammatory drugs.We studied the characteristics of all (...) patients with acute upper gastrointestinal haemorrhage and attending a single hospital at 3 points over a 6-year period: 1996 (n = 204), 1999 (n = 224) and in 2002 (n = 252).The incidence of haemorrhage in subjects taking low-dose aspirin rose from 15 per 100 000 of the population per annum in 1996, to 18 in 1999 and 27 in 2002 (P = 0.004). The respective incidence in subjects taking other anti-thrombotic drugs was 4, 8, and 12 (P < 0.001). No significant change was detected in non-steroidal anti

2005 Alimentary Pharmacology & Therapeutics

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