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GI bleeding risk associated with simultaneous use of oral glucocorticoids with NOACs: BMJ
Concomitant use of non-vitamin K oral anticoagulants (NOAC) and oral glucocorticoids significantly associated with increased risk of gastrointestinal bleeding, suggests a study published in the Heart- BMJ journal.
Gastrointestinal bleeding (GIB) risk in relation to concomitant treatment with non-vitamin K oral anticoagulants (NOAC) and oral glucocorticoids is insufficiently explored.
A study was conducted by Holt A et. al to investigate the short-term risk following co-exposure of non-vitamin K oral anticoagulants (NOAC) and oral glucocorticoids
The researchers conducted a nationwide Danish study including patients with atrial fibrillation on NOACs during 2012–2018. Patients were defined as exposed to oral glucocorticoids if they claimed a prescription within 60 days prior to Gastrointestinal bleeding (GIB). They investigated the associations between Gastrointestinal bleeding (GIB) and oral glucocorticoid exposure, reporting HRs via a nested case-control design and absolute risk via a cohort design. Matching terms were age, sex, calendar year, follow-up time and non-vitamin K oral anticoagulant (NOAC) agent.
The results of the study are as follows:
- 98,376 patients on non-vitamin K oral anticoagulants (NOACs) were included, and 16% redeemed at least one oral glucocorticoid prescription within 3 years.
- HRs of Gastrointestinal bleeding (GIB) were increased comparing exposed with non-exposed patients.
- 60-day the standardised absolute risk of GIB following first claimed oral glucocorticoid prescription increased compared with non-exposed: 60-day absolute risk: 0.71% vs 0.38%
- The relative risk was elevated as well: risk ratio of 1.89
Thus, the researchers concluded that concomitant treatment with non-vitamin K oral anticoagulants (NOACs) and oral glucocorticoids was associated with a short-term rate and risk increase of Gastrointestinal bleeding (GIB) compared with patients only on non-vitamin K oral anticoagulants (NOACs). This could have implications for clinical management, necessitating closer monitoring or other risk mitigation strategies during episodes of cotreatment with oral glucocorticoids.
Reference:
Gastrointestinal bleeding risk following concomitant treatment with oral glucocorticoids in patients on non-vitamin K oral anticoagulants by Holt A et. al published in the Heart-BMJ journal.
doi: 10.1136/heartjnl-2021-319503
Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751