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Argirios Argiriou:
BMJ 1996: 312: 1563.

Variability in risk of gastrointestinal complications with individual
non-steroidal anti-inflammatory drugs: results of a collaborative
meta-analysis.

David Henry, Lynette L-Y rim, Luis A Garcia Rodriguez, Susanne Perez Gutthann, Jeffrey L
Carson, Marie Griffin, Ruth Savage, Richard Logan,Yola Moride, Chris Hawkey, Suzanne Hill,
James T Fries

Correspondence to:
Dr David Henry, Centre for
Clinical Epidemiology and
Biostatistics, Royal
Newcastle Hospital,
Newcastle, NSW2300,
Australia.
mddah®alinga.newcastle.
edu.au

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Key messages.

* Gastrointestinal complications of treatment with
non-steroidal anti-inflammatory drugs are a major
cause of morbidity and mortality

* Because there are no important differences in
efficacy, choice of first line treatment with these
drugs should be based on their relative toxicity

* Meta-analysis of the available epidemiological
studies shows wide differences between individual
drugs in the risk of inducing gastrointestinal bleeding and ulcer perforation

* Of the drugs in common use, ibuprofen and
diclofenac rank low in toxicity whereas azapropazone, ketoprofen, and piroxicam rank high

* Some of the differences between drugs may be
explained by dose, and the advantage of "low risk"
drugs may be lost once their dose is increased

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