Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study
Patients with inflammatory bowel disease (IBD) often have associated conditions, for which anti-inflammatory medication with cyclo-oxygenase (COX) inhibitors may be helpful. The current evidence is conflicting regarding the role of COX-inhibitors in causing relapse in IBD. This case-control study ex...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2015-09-01
|
| Series: | Pharmaceuticals |
| Subjects: | |
| Online Access: | http://www.mdpi.com/1424-8247/8/3/512 |
| _version_ | 1818299102955307008 |
|---|---|
| author | Abigail Hensley Ian L. P. Beales |
| author_facet | Abigail Hensley Ian L. P. Beales |
| author_sort | Abigail Hensley |
| collection | DOAJ |
| description | Patients with inflammatory bowel disease (IBD) often have associated conditions, for which anti-inflammatory medication with cyclo-oxygenase (COX) inhibitors may be helpful. The current evidence is conflicting regarding the role of COX-inhibitors in causing relapse in IBD. This case-control study examined the association between the use of COX inhibitors and relapse of IBD. Logistic regression was used to analyse the relationship between COX-inhibitors and IBD relapse. Overall COX inhibitor use (combined non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 agents) had a negative association with relapse of IBD (adjusted OR 0.26, 95% CI 0.09–0.80). This negative association was confined to ulcerative colitis (UC) (adjusted OR = 0.06, 95% CI 0.01–0.50) and no association was found in Crohn’s disease (CD) patients (adjusted OR 1.25, 95% CI 0.18–7.46). The significant negative association between UC relapse and medication use was also seen with non-specific NSAIDs. Selective COX-2 inhibitor use was rare but non-significantly more common in stable patients. There was no association between low-dose aspirin or paracetamol use and relapse of CD or UC. We conclude that COX-inhibitor use was not associated with an increased risk of relapse in UC or CD, and may be protective in UC. Where indicated, NSAIDs should not be withheld from IBD patients. |
| first_indexed | 2024-12-13T04:45:54Z |
| format | Article |
| id | doaj.art-40567758b312456f9a9d479e4ce8d8e8 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-12-13T04:45:54Z |
| publishDate | 2015-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-40567758b312456f9a9d479e4ce8d8e82022-12-21T23:59:09ZengMDPI AGPharmaceuticals1424-82472015-09-018351252410.3390/ph8030512ph8030512Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control StudyAbigail Hensley0Ian L. P. Beales1Norwich Medical School, University of East Anglia, Norwich 06360, UKNorwich Medical School, University of East Anglia, Norwich 06360, UKPatients with inflammatory bowel disease (IBD) often have associated conditions, for which anti-inflammatory medication with cyclo-oxygenase (COX) inhibitors may be helpful. The current evidence is conflicting regarding the role of COX-inhibitors in causing relapse in IBD. This case-control study examined the association between the use of COX inhibitors and relapse of IBD. Logistic regression was used to analyse the relationship between COX-inhibitors and IBD relapse. Overall COX inhibitor use (combined non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 agents) had a negative association with relapse of IBD (adjusted OR 0.26, 95% CI 0.09–0.80). This negative association was confined to ulcerative colitis (UC) (adjusted OR = 0.06, 95% CI 0.01–0.50) and no association was found in Crohn’s disease (CD) patients (adjusted OR 1.25, 95% CI 0.18–7.46). The significant negative association between UC relapse and medication use was also seen with non-specific NSAIDs. Selective COX-2 inhibitor use was rare but non-significantly more common in stable patients. There was no association between low-dose aspirin or paracetamol use and relapse of CD or UC. We conclude that COX-inhibitor use was not associated with an increased risk of relapse in UC or CD, and may be protective in UC. Where indicated, NSAIDs should not be withheld from IBD patients.http://www.mdpi.com/1424-8247/8/3/512Crohn’s diseaseUlcerative colitiscyclo-oxygenasenon-steroidal anti-inflammatory drug |
| spellingShingle | Abigail Hensley Ian L. P. Beales Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study Pharmaceuticals Crohn’s disease Ulcerative colitis cyclo-oxygenase non-steroidal anti-inflammatory drug |
| title | Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study |
| title_full | Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study |
| title_fullStr | Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study |
| title_full_unstemmed | Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study |
| title_short | Use of Cyclo-Oxygenase Inhibitors Is Not Associated with Clinical Relapse in Inflammatory Bowel Disease: A Case-Control Study |
| title_sort | use of cyclo oxygenase inhibitors is not associated with clinical relapse in inflammatory bowel disease a case control study |
| topic | Crohn’s disease Ulcerative colitis cyclo-oxygenase non-steroidal anti-inflammatory drug |
| url | http://www.mdpi.com/1424-8247/8/3/512 |
| work_keys_str_mv | AT abigailhensley useofcyclooxygenaseinhibitorsisnotassociatedwithclinicalrelapseininflammatoryboweldiseaseacasecontrolstudy AT ianlpbeales useofcyclooxygenaseinhibitorsisnotassociatedwithclinicalrelapseininflammatoryboweldiseaseacasecontrolstudy |