Immunosuppressive agents are associated with peptic ulcer bleeding

Tomizawa,Minoru; Shinozaki,Fuminobu; Hasegawa,Rumiko; Shirai,Yoshinori; Motoyoshi,Yasufumi; Sugiyama,Takao; Yamamoto,Shigenori; Ishige,Naoki

doi:10.3892/etm.2017.4214

Immunosuppressive agents are associated with peptic ulcer bleeding

Authors:
- Minoru Tomizawa
- Fuminobu Shinozaki
- Rumiko Hasegawa
- Yoshinori Shirai
- Yasufumi Motoyoshi
- Takao Sugiyama
- Shigenori Yamamoto
- Naoki Ishige
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Affiliations: Department of Gastroenterology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan, Department of Radiology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan, Department of Surgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan, Department of Neurology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan, Department of Rheumatology, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan, Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan, Department of Neurosurgery, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba 284‑0003, Japan
Published online on: March 9, 2017 https://doi.org/10.3892/etm.2017.4214
Pages: 1927-1931

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Abstract

Peptic ulcer bleeding can be fatal. Non‑steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and immunosuppressive agents are administered for long‑term usage. The present study assessed the association between peptic ulcer bleeding and administration of NSAIDs, corticosteroids and immunosuppressive agents. Furthermore, the efficacy of lowering the risk of peptic ulcer bleeding with proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) was evaluated. Medical records were retrospectively analyzed for patients subjected to an upper gastrointestinal (GI) endoscopy performed at the National Hospital Organization Shimoshizu Hospital (Yotsukaido, Japan) from October 2014 to September 2015. During this period, a total of 1,023 patients underwent an upper GI endoscopy. A total of 1,023 patients, including 431 males (age, 68.1±12.9 years) and 592 females (age, 66.4±12.3 years), who had been administered NSAIDs, corticosteroids, immunosuppressive agents, PPIs and H2RAs, were respectively enrolled. Endoscopic findings of the patients were reviewed and their data were statistically analyzed. Logistic regression analysis was used to determine the odds ratio of peptic ulcer bleeding for each medication; immunosuppressive agents had an odds ratio of 5.83, which was larger than that for NSAIDs (4.77). The Wald test was applied to confirm the correlation between immunosuppressive agents and peptic ulcer bleeding. Furthermore, χ2 tests were applied to the correlation between peptic ulcer bleeding and administration of PPIs or H2RAs. Immunosuppressive agents had the largest χ2, and the P‑value was 0.03. Administration of PPIs was significantly correlated with non‑peptic ulcer bleeding (P=0.02); furthermore, a tendency toward non‑peptic ulcer bleeding with administration of H2RA was indicated, but it was not statistically significant (P=0.12). In conclusion, immunosuppressive agents were correlated with peptic ulcer bleeding and PPIs were effective at lowering the risk of peptic ulcer bleeding.

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