Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs

Lydia Say Lee Pok, Fatiha Hana Shabaruddin, Maznah Dahlui, Sargunan Sockalingam, Mohd Shahrir Mohamed Said, Azmillah Rosman, Ing Soo Lau, Liza Mohd Isa, Heselynn Hussein, Chin Teck Ng, Sanjiv Mahadeva

Research output: Contribution to journalArticle

Abstract

Aim: To determine the incidence and direct costs of NSAID-induced upper GI adverse events in Malaysian rheumatology patients. Methods: A retrospective, multi-centre, cohort study of rheumatology patients on long-term NSAIDs was conducted. Clinical data of patients treated between 2010 and 2013 were collected for a 24-month follow-up period. The costs of managing upper GI adverse events were based on patient level resource use data. Results: Six hundred and thirty-four patients met the inclusion criteria: mean age 53.4 years, 89.9% female, diagnosis of rheumatoid arthritis (RA; 59.3%), osteoarthritis (OA; 10.3%) and both RA and OA (30.3%). Three hundred and seventy-one (58.5%) patients were prescribed non-selective NSAIDs and 263 (41.5%) had cyclo-oxygenase-2 inhibitors. Eighty-four upper GI adverse events occurred, translating into a risk of 13.2% and an incidence rate of 66.2 per 1000 person-years. GI adverse events comprised: dyspepsia n = 78 (12.3%), peptic ulcer disease (PUD) n = 5 (0.79%) and upper GI bleeding (UGIB) n = 1 (0.16%). The total direct healthcare cost of managing adverse events was Malaysian Ringgit (MR) 37 352 (US dollars [USD] 11 419) with a mean cost of MR 446.81 ± 534.56 (USD 136.60 ± 163.42) per patient, consisting mainly of GI pharmacotherapy (33.8%), oesophagoduodenoscopies (23.1%) and outpatient clinic visits (18.2%). Mean cost per patient by GI events were: dyspepsia, MR 408.98 ± 513.29 (USD125.03 ± 156.92); PUD, MR 805.93 ± 578.80 (USD 246.39 ± 176.95); UGIB, MR 1601.94 (USD 489.74, n = 1). Conclusion: The economic burden of GI adverse events due to long-term NSAIDs use in Malaysian patients with chronic rheumatic diseases is modest.

Original languageEnglish
Pages (from-to)943-951
Number of pages9
JournalInternational Journal of Rheumatic Diseases
Volume21
Issue number5
DOIs
Publication statusPublished - 1 May 2018

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Anti-Inflammatory Agents
Economics
Non-Steroidal Anti-Inflammatory Agents
Pharmaceutical Preparations
Costs and Cost Analysis
Dyspepsia
Rheumatology
Peptic Ulcer
Hemorrhage
Cyclooxygenase Inhibitors
Incidence
Ambulatory Care
Ambulatory Care Facilities
Rheumatic Diseases
Osteoarthritis
Health Care Costs
Rheumatoid Arthritis
Chronic Disease
Cohort Studies
Drug Therapy

Keywords

  • economic implication
  • non-steroidal anti-inflammatory drugs
  • upper gastrointestinal adverse event

ASJC Scopus subject areas

  • Rheumatology

Cite this

Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs. / Pok, Lydia Say Lee; Shabaruddin, Fatiha Hana; Dahlui, Maznah; Sockalingam, Sargunan; Mohamed Said, Mohd Shahrir; Rosman, Azmillah; Lau, Ing Soo; Isa, Liza Mohd; Hussein, Heselynn; Ng, Chin Teck; Mahadeva, Sanjiv.

In: International Journal of Rheumatic Diseases, Vol. 21, No. 5, 01.05.2018, p. 943-951.

Research output: Contribution to journalArticle

Pok, Lydia Say Lee ; Shabaruddin, Fatiha Hana ; Dahlui, Maznah ; Sockalingam, Sargunan ; Mohamed Said, Mohd Shahrir ; Rosman, Azmillah ; Lau, Ing Soo ; Isa, Liza Mohd ; Hussein, Heselynn ; Ng, Chin Teck ; Mahadeva, Sanjiv. / Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs. In: International Journal of Rheumatic Diseases. 2018 ; Vol. 21, No. 5. pp. 943-951.
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abstract = "Aim: To determine the incidence and direct costs of NSAID-induced upper GI adverse events in Malaysian rheumatology patients. Methods: A retrospective, multi-centre, cohort study of rheumatology patients on long-term NSAIDs was conducted. Clinical data of patients treated between 2010 and 2013 were collected for a 24-month follow-up period. The costs of managing upper GI adverse events were based on patient level resource use data. Results: Six hundred and thirty-four patients met the inclusion criteria: mean age 53.4 years, 89.9{\%} female, diagnosis of rheumatoid arthritis (RA; 59.3{\%}), osteoarthritis (OA; 10.3{\%}) and both RA and OA (30.3{\%}). Three hundred and seventy-one (58.5{\%}) patients were prescribed non-selective NSAIDs and 263 (41.5{\%}) had cyclo-oxygenase-2 inhibitors. Eighty-four upper GI adverse events occurred, translating into a risk of 13.2{\%} and an incidence rate of 66.2 per 1000 person-years. GI adverse events comprised: dyspepsia n = 78 (12.3{\%}), peptic ulcer disease (PUD) n = 5 (0.79{\%}) and upper GI bleeding (UGIB) n = 1 (0.16{\%}). The total direct healthcare cost of managing adverse events was Malaysian Ringgit (MR) 37 352 (US dollars [USD] 11 419) with a mean cost of MR 446.81 ± 534.56 (USD 136.60 ± 163.42) per patient, consisting mainly of GI pharmacotherapy (33.8{\%}), oesophagoduodenoscopies (23.1{\%}) and outpatient clinic visits (18.2{\%}). Mean cost per patient by GI events were: dyspepsia, MR 408.98 ± 513.29 (USD125.03 ± 156.92); PUD, MR 805.93 ± 578.80 (USD 246.39 ± 176.95); UGIB, MR 1601.94 (USD 489.74, n = 1). Conclusion: The economic burden of GI adverse events due to long-term NSAIDs use in Malaysian patients with chronic rheumatic diseases is modest.",
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AU - Shabaruddin, Fatiha Hana

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AU - Sockalingam, Sargunan

AU - Mohamed Said, Mohd Shahrir

AU - Rosman, Azmillah

AU - Lau, Ing Soo

AU - Isa, Liza Mohd

AU - Hussein, Heselynn

AU - Ng, Chin Teck

AU - Mahadeva, Sanjiv

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N2 - Aim: To determine the incidence and direct costs of NSAID-induced upper GI adverse events in Malaysian rheumatology patients. Methods: A retrospective, multi-centre, cohort study of rheumatology patients on long-term NSAIDs was conducted. Clinical data of patients treated between 2010 and 2013 were collected for a 24-month follow-up period. The costs of managing upper GI adverse events were based on patient level resource use data. Results: Six hundred and thirty-four patients met the inclusion criteria: mean age 53.4 years, 89.9% female, diagnosis of rheumatoid arthritis (RA; 59.3%), osteoarthritis (OA; 10.3%) and both RA and OA (30.3%). Three hundred and seventy-one (58.5%) patients were prescribed non-selective NSAIDs and 263 (41.5%) had cyclo-oxygenase-2 inhibitors. Eighty-four upper GI adverse events occurred, translating into a risk of 13.2% and an incidence rate of 66.2 per 1000 person-years. GI adverse events comprised: dyspepsia n = 78 (12.3%), peptic ulcer disease (PUD) n = 5 (0.79%) and upper GI bleeding (UGIB) n = 1 (0.16%). The total direct healthcare cost of managing adverse events was Malaysian Ringgit (MR) 37 352 (US dollars [USD] 11 419) with a mean cost of MR 446.81 ± 534.56 (USD 136.60 ± 163.42) per patient, consisting mainly of GI pharmacotherapy (33.8%), oesophagoduodenoscopies (23.1%) and outpatient clinic visits (18.2%). Mean cost per patient by GI events were: dyspepsia, MR 408.98 ± 513.29 (USD125.03 ± 156.92); PUD, MR 805.93 ± 578.80 (USD 246.39 ± 176.95); UGIB, MR 1601.94 (USD 489.74, n = 1). Conclusion: The economic burden of GI adverse events due to long-term NSAIDs use in Malaysian patients with chronic rheumatic diseases is modest.

AB - Aim: To determine the incidence and direct costs of NSAID-induced upper GI adverse events in Malaysian rheumatology patients. Methods: A retrospective, multi-centre, cohort study of rheumatology patients on long-term NSAIDs was conducted. Clinical data of patients treated between 2010 and 2013 were collected for a 24-month follow-up period. The costs of managing upper GI adverse events were based on patient level resource use data. Results: Six hundred and thirty-four patients met the inclusion criteria: mean age 53.4 years, 89.9% female, diagnosis of rheumatoid arthritis (RA; 59.3%), osteoarthritis (OA; 10.3%) and both RA and OA (30.3%). Three hundred and seventy-one (58.5%) patients were prescribed non-selective NSAIDs and 263 (41.5%) had cyclo-oxygenase-2 inhibitors. Eighty-four upper GI adverse events occurred, translating into a risk of 13.2% and an incidence rate of 66.2 per 1000 person-years. GI adverse events comprised: dyspepsia n = 78 (12.3%), peptic ulcer disease (PUD) n = 5 (0.79%) and upper GI bleeding (UGIB) n = 1 (0.16%). The total direct healthcare cost of managing adverse events was Malaysian Ringgit (MR) 37 352 (US dollars [USD] 11 419) with a mean cost of MR 446.81 ± 534.56 (USD 136.60 ± 163.42) per patient, consisting mainly of GI pharmacotherapy (33.8%), oesophagoduodenoscopies (23.1%) and outpatient clinic visits (18.2%). Mean cost per patient by GI events were: dyspepsia, MR 408.98 ± 513.29 (USD125.03 ± 156.92); PUD, MR 805.93 ± 578.80 (USD 246.39 ± 176.95); UGIB, MR 1601.94 (USD 489.74, n = 1). Conclusion: The economic burden of GI adverse events due to long-term NSAIDs use in Malaysian patients with chronic rheumatic diseases is modest.

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