Endoscopic evidence of mucosal injury in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs and controls

Rafiq A. Sheikh, Patrick S Romano, Thomas P Prindiville, Shagufta Yasmeen, Walter Trudeau

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17 Citations (Scopus)

Abstract

Background: Ticlopidine is a novel antiplatelet agent used alone or in combination with aspirin and anticoagulants in the treatment and prevention of various vascular diseases. Gastrointestinal side effects, including bleeding, have been reported with use of ticlopidine in most of the vascular prevention trials. We studied the endoscopic evidence of mucosal damage in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs (NSAIDs) and matched controls. Study: We performed a longitudinal review of gastrointestinal endoscopy, pharmacy databases, and medical records of patients referred to our service over a period of 6 months for endoscopic evaluation of upper gastrointestinal bleeding, unexplained anemia, or abdominal pain. Data were collected and analyzed for 55 patients taking ticlopidine, 77 age- and gender-matched patients taking aspirin or NSAIDs, and 560 age- and gender-matched control patients not taking any of these medications. Results: The overall prevalence of ulcers was marginally higher in the aspirin/NSAID group than in the ticlopidine group (35% vs. 29%) and was significantly higher among patients taking aspirin, NSAIDs, or ticlopidine than among controls (15%). Gastritis was also noted more frequently in the aspirin/NSAID and ticlopidine groups than in the control group. Endoscopic evidence of esophagitis was significantly more frequent in the control group than in the aspirin/NSAID and ticlopidine groups. There was no significant difference across groups in the prevalence of ulcers, gastritis, or esophagitis. Conclusions: Patients taking ticlopidine are more likely to have endoscopic evidence of mucosal damage than matched control patients and are nearly as likely to have such damage as endoscopically evaluated patients taking aspirin or NSAIDs. However, these findings must be confirmed using prospective cohort data for patients in primary care settings, to avoid referral bias.

Original languageEnglish (US)
Pages (from-to)529-532
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume34
Issue number5
DOIs
StatePublished - 2002

Fingerprint

Ticlopidine
Drug and Narcotic Control
Aspirin
Anti-Inflammatory Agents
Wounds and Injuries
Pharmaceutical Preparations
Esophagitis
Gastritis
Ulcer
Hemorrhage
Control Groups
Gastrointestinal Endoscopy
Platelet Aggregation Inhibitors
Vascular Diseases
Anticoagulants
Abdominal Pain
Medical Records
Blood Vessels
Anemia
Primary Health Care

Keywords

  • Gastritis
  • Hemorrhage
  • Ticlid
  • Ticlopidine
  • Ulcer

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{6f421e1b4e91484eaf4cf2d92039f6b3,
title = "Endoscopic evidence of mucosal injury in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs and controls",
abstract = "Background: Ticlopidine is a novel antiplatelet agent used alone or in combination with aspirin and anticoagulants in the treatment and prevention of various vascular diseases. Gastrointestinal side effects, including bleeding, have been reported with use of ticlopidine in most of the vascular prevention trials. We studied the endoscopic evidence of mucosal damage in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs (NSAIDs) and matched controls. Study: We performed a longitudinal review of gastrointestinal endoscopy, pharmacy databases, and medical records of patients referred to our service over a period of 6 months for endoscopic evaluation of upper gastrointestinal bleeding, unexplained anemia, or abdominal pain. Data were collected and analyzed for 55 patients taking ticlopidine, 77 age- and gender-matched patients taking aspirin or NSAIDs, and 560 age- and gender-matched control patients not taking any of these medications. Results: The overall prevalence of ulcers was marginally higher in the aspirin/NSAID group than in the ticlopidine group (35{\%} vs. 29{\%}) and was significantly higher among patients taking aspirin, NSAIDs, or ticlopidine than among controls (15{\%}). Gastritis was also noted more frequently in the aspirin/NSAID and ticlopidine groups than in the control group. Endoscopic evidence of esophagitis was significantly more frequent in the control group than in the aspirin/NSAID and ticlopidine groups. There was no significant difference across groups in the prevalence of ulcers, gastritis, or esophagitis. Conclusions: Patients taking ticlopidine are more likely to have endoscopic evidence of mucosal damage than matched control patients and are nearly as likely to have such damage as endoscopically evaluated patients taking aspirin or NSAIDs. However, these findings must be confirmed using prospective cohort data for patients in primary care settings, to avoid referral bias.",
keywords = "Gastritis, Hemorrhage, Ticlid, Ticlopidine, Ulcer",
author = "Sheikh, {Rafiq A.} and Romano, {Patrick S} and Prindiville, {Thomas P} and Shagufta Yasmeen and Walter Trudeau",
year = "2002",
doi = "10.1097/00004836-200205000-00009",
language = "English (US)",
volume = "34",
pages = "529--532",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
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TY - JOUR

T1 - Endoscopic evidence of mucosal injury in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs and controls

AU - Sheikh, Rafiq A.

AU - Romano, Patrick S

AU - Prindiville, Thomas P

AU - Yasmeen, Shagufta

AU - Trudeau, Walter

PY - 2002

Y1 - 2002

N2 - Background: Ticlopidine is a novel antiplatelet agent used alone or in combination with aspirin and anticoagulants in the treatment and prevention of various vascular diseases. Gastrointestinal side effects, including bleeding, have been reported with use of ticlopidine in most of the vascular prevention trials. We studied the endoscopic evidence of mucosal damage in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs (NSAIDs) and matched controls. Study: We performed a longitudinal review of gastrointestinal endoscopy, pharmacy databases, and medical records of patients referred to our service over a period of 6 months for endoscopic evaluation of upper gastrointestinal bleeding, unexplained anemia, or abdominal pain. Data were collected and analyzed for 55 patients taking ticlopidine, 77 age- and gender-matched patients taking aspirin or NSAIDs, and 560 age- and gender-matched control patients not taking any of these medications. Results: The overall prevalence of ulcers was marginally higher in the aspirin/NSAID group than in the ticlopidine group (35% vs. 29%) and was significantly higher among patients taking aspirin, NSAIDs, or ticlopidine than among controls (15%). Gastritis was also noted more frequently in the aspirin/NSAID and ticlopidine groups than in the control group. Endoscopic evidence of esophagitis was significantly more frequent in the control group than in the aspirin/NSAID and ticlopidine groups. There was no significant difference across groups in the prevalence of ulcers, gastritis, or esophagitis. Conclusions: Patients taking ticlopidine are more likely to have endoscopic evidence of mucosal damage than matched control patients and are nearly as likely to have such damage as endoscopically evaluated patients taking aspirin or NSAIDs. However, these findings must be confirmed using prospective cohort data for patients in primary care settings, to avoid referral bias.

AB - Background: Ticlopidine is a novel antiplatelet agent used alone or in combination with aspirin and anticoagulants in the treatment and prevention of various vascular diseases. Gastrointestinal side effects, including bleeding, have been reported with use of ticlopidine in most of the vascular prevention trials. We studied the endoscopic evidence of mucosal damage in patients taking ticlopidine compared with patients taking aspirin/nonsteroidal antiinflammatory drugs (NSAIDs) and matched controls. Study: We performed a longitudinal review of gastrointestinal endoscopy, pharmacy databases, and medical records of patients referred to our service over a period of 6 months for endoscopic evaluation of upper gastrointestinal bleeding, unexplained anemia, or abdominal pain. Data were collected and analyzed for 55 patients taking ticlopidine, 77 age- and gender-matched patients taking aspirin or NSAIDs, and 560 age- and gender-matched control patients not taking any of these medications. Results: The overall prevalence of ulcers was marginally higher in the aspirin/NSAID group than in the ticlopidine group (35% vs. 29%) and was significantly higher among patients taking aspirin, NSAIDs, or ticlopidine than among controls (15%). Gastritis was also noted more frequently in the aspirin/NSAID and ticlopidine groups than in the control group. Endoscopic evidence of esophagitis was significantly more frequent in the control group than in the aspirin/NSAID and ticlopidine groups. There was no significant difference across groups in the prevalence of ulcers, gastritis, or esophagitis. Conclusions: Patients taking ticlopidine are more likely to have endoscopic evidence of mucosal damage than matched control patients and are nearly as likely to have such damage as endoscopically evaluated patients taking aspirin or NSAIDs. However, these findings must be confirmed using prospective cohort data for patients in primary care settings, to avoid referral bias.

KW - Gastritis

KW - Hemorrhage

KW - Ticlid

KW - Ticlopidine

KW - Ulcer

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U2 - 10.1097/00004836-200205000-00009

DO - 10.1097/00004836-200205000-00009

M3 - Article

C2 - 11960063

AN - SCOPUS:0036228548

VL - 34

SP - 529

EP - 532

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 5

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