A new study has found no convincing evidence to suggest a causal relationship between NSAID use and IBD exacerbations. GastroTwitter
Patients with IBD are prone to both inflammatory and noninflammatory pain, and there has been long-standing concern that NSAIDs may play a role in disease flare-ups.
First, they created a propensity-matched cohort of 15,705 patients who had received NSAIDs and 19,326 who had not taken NSAIDs. Findings from a Cox proportional hazards model suggested a higher likelihood of IBD exacerbation in the group that had taken NSAIDs , after adjusting for age, gender, race, Charlson comorbidity index, smoking status, IBD type, and use of immunomodulator or biologic medications.
The researchers used a self-controlled case series to verify their findings and to adjust for other immeasurable patient-level confounders. In this analysis, which involved 3968 patients, the risk of IBD flare did not increase in the period from 2 weeks to 6 months after exposure to an NSAID. While NSAIDs represent the most common first-line analgesic, their use for patients with IBD is variable, in part due to the suspected risk of IBD exacerbation"despite inconclusive evidence of harm to date," Cohen-Mekelburg and colleagues note.
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