Causation: Recurrent Collagenous Colitis Following Repeated Use of NSAIDs (original) (raw)

Address of the authors GASTROINTESTINAL COMPLICATIONS DURING USE OF ANTI-INFLAMMATORY DRUGS

INTRODUCTION Inflammation can be triggered by infectious, chemical and physical causes. Several fac-tors contribute to its development, such as E-, P-, L-selectin, intercellular adhesion mole-cules (ICAM-1), vascular adhesion molecules (VCAM-1), soluble mediators such as inter-leukins (IL)-1, (IL)-2, (IL)-6 and (IL)-8, as well as tumor necrosis factor, whose concentra-tion increases significantly in the synovium of patients with joint diseases. The soluble inflammation mediators are responsible for the production of PGE 1 and PGE 2 that insti-gate the development of clinical signs of inflammation. The use of Non-Steroidal Anti-inflammatory Drugs (NSAIDs) is essential for reaching therapeutic goals. The main ef-fects of NSAIDs derive from their ability to inhibit the synthesis of prostaglandins by blocking the function of cyclooxygenase. There are two isoforms of cyclooxygenase (COX); the first, COX-1[1], is the constitutive isoform found in most tissues, while the second, COX-2, is ...

High risk of drug-induced microscopic colitis with concomitant use of NSAIDs and proton pump inhibitors

Alimentary pharmacology & therapeutics, 2016

Microscopic colitis (MC) is a chronic bowel disorder characterised by watery diarrhoea. Nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs) and statins have been associated with MC. However, underlying mechanisms remain unclear. To study the association between exposure to these drugs and MC, with attention to time of exposure, duration, dosage and combined exposure, and to test hypotheses on underlying pharmacological mechanisms. A case-control study was conducted using the British Clinical Practice Research Datalink. MC cases (1992-2013) were matched to MC-naive controls on age, sex and GP practice. Drug exposure was stratified according to time of exposure, duration of exposure or dosage. Conditional logistic regression analysis was applied to calculate adjusted odds ratios (AORs). In total, 1211 cases with MC were matched to 6041 controls. Mean age was 63.4 years, with 73.2% being female. Current use of NS...