The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combinations of these agents

Table 2 Relative risk (RR) and 95% confidence interval (CI) of upper gastrointestinal complications associated with combined use of anti-inflammatory drugs

Anti-inflammatory
drugs	Cases (n)	Controls (n)	RR^*	95% CI
None^†	852	6768	Reference
Steroids alone	41	132	2.1	1.4–3.0
Aspirin alone	177	609	2.4	1.9–2.9
NA-NSAIDs alone	193	489	3.6	2.9–4.3
Acetaminophen (< 2 g)	96	565	1.1	0.9–1.4
Acetaminophen (≥ 2 g)	52	124	2.4	1.7–3.5
Steroids and aspirin	6	17	3.1	1.2–8.1
Steroids and NA-NSAIDs	14	13	8.5	3.9–18.9
Steroids and acetaminophen (< 2 g)	5	31	1.1	0.4–2.9
Steroids and acetaminophen (≥ 2 g)	4	5	4.8	1.1–20.9
Aspirin and NA-NSAIDs	40	50	8.2	5.3–12.8
Aspirin and acetaminophen (< 2 g)	16	94	1.3	0.7–2.3
Aspirin and acetaminophen (≥ 2 g)	14	32	3.3	1.7–6.5
NA-NSAIDs and acetaminophen (< 2 g)	61	134	4.1	3.0–5.7
NA-NSAIDs and acetaminophen (≥ 2 g)	80	41	16.6	11.0–24.9
Three or four anti-inflammatory drugs^‡	27	13	18.0	9.0–36.1

Data are for United Kingdom General Practice Research Database, 1993–1998. NA-NSAIDs, Nonaspirin nonsteroidal anti-inflammatory drugs. ^*Adjusted for age, sex, calendar year, ulcer history, smoking, and concomitant medications. These analyses include only current users versus non-users (no use in the past 180 days); data on recent past (between 30 and 180 days) users are not presented. ^†Patients exposed to no drug (steroids, aspirin, NA-NSAIDs, and acetaminophen). Categories are mutually exclusive. ^‡Acetaminophen at doses < 2 g not included in this category.

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