Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure

We observed that 220 (27%) cases and 272 (31%) controls had ever used all-NSAIDs (OR , 95% CI –) (Table  3 ). The association decreased with the frequency of use (OR , 95% CI – for less than 1 use per day; OR , 95% CI – for 1 use per day; OR , 95% CI – for more than 1 use per day; P trend = ) and was more pronounced for a duration of 5–10 years (OR , 95% CI –), for a current use (OR , 95% CI –), and when the NSAIDs use had a preferentially anti-COX-2 activity (OR , 95% CI –).

SOURCES: Byron Cryer, MD, spokesman, American Gastroenterological Association; associate professor of medicine, University of Texas Southwestern Medical Center, Dallas. Nieca Goldberg, MD, spokeswoman for the American Heart Association; chief of women's cardiac care, Lennox Hill Hospital, New York; author, Women Are Not Small Men: Lifesaving Strategies For Preventing And Healing Heart Disease In Women . John Klippel, MD, president and CEO, Arthritis Foundation, Atlanta. Scott Zashin, clinical assistant professor, University of Texas Southwestern Medical Center; author of Arthritis Without Pain . American College of Rheumatology web site. Arthritis Foundation web site. American Heart Association web site. American College of Gastroenterology web site. American Gastroenterological Association web site. American Academy of Family Physicians web site. American Academy of Allergy, Asthma, and Immunology web site.

FDA reviewed a meta-analysis of randomized clinical trials of cardiovascular and upper gastrointestinal events with non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), conducted by the Coxib and traditional NSAID Trialists’ (CNT) Collaboration of the Clinical Trial Service and Epidemiological Studies Units at Oxford University. 2 We also reviewed observational studies and other scientific publications in the medical literature. 1 The findings of these studies were discussed at a joint meeting of the Arthritis Advisory Committee and Drug Safety and Risk Management Advisory Committee held on February 10-11, 2014 (for complete safety reviews, background information, and minutes of this meeting, click here ).

Although different NSAIDs have different structures, they all work by blocking cyclo-oxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation.

Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure

nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure

Although different NSAIDs have different structures, they all work by blocking cyclo-oxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation.

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