Document Type
Conference Proceeding
Publication Date
5-3-2024
Abstract
Introduction: Initial studies seemed to show that NSAID use was associated with increased risk of IBD exacerbation. Supported by known role of COX-1/2 isoenzymes (specifically their prostaglandin [PG] products) in maintaining GI mucosal barrier and mediating inflammation Combination of early research findings and COX prostaglandin knowledge resulted in NSAID avoidance in IBD patients. Recent data seemingly contradicts prior research, and NSAID use is predicted to not play a role in IBD exacerbation Methods: We conducted a systematic review of the literature using PubMed and American Journal of Gastroenterology. Of the thousands of results, we narrowed our results to 4 recent studies using inclusion criteria of IBD and NSAID association, non-pediatric sample, and publication date between 2000-2023. Results: 3 out of the 4 included studies overtly found no association between NSAID use and IBD exacerbation. The other initially found an association using traditional study methods. However, due to a suspicion for bias interference, they ran a follow up study that showed similar exacerbation rates prior to and after NSAID exposure (except in 0-2 weeks post-exposure which they attributed to reverse causality confounding). Conclusion: Although recent data refutes the association between NSAIDs and IBD exacerbation, the evidence is not conclusive. Continued investigation should occur before deciding whether NSAIDs have any role in IBD therapy. It is especially important in situations with IBD patients that have concurrent inflammatory disorders, of which NSAIDs are a primary therapy.
Recommended Citation
Swartz A, Hettiarachchi M. NSAIDs role in triggering IBD exacerbations; reality or misunderstanding? A systematic review. Presented at: American College of Physicians Michigan Chapter and Society of Hospital Medicine Michigan Chapter 2024 Resident and Medical Student Day; 2024 May 3; Troy, MI
Comments
American College of Physicians Michigan Chapter and Society of Hospital Medicine Michigan Chapter 2024 Resident and Medical Student Day, May 3, 2024, Troy, MI