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Nonsteroidal Anti-inflammatory Drugs and Gastrointestinal Injury in Children

Nonsteroidal Anti-inflammatory Drugs and Gastrointestinal Injury in Children Abstract Sir.—I read with interest the timely article by Lindsley1 published in the February 1993 issue of AJDC on nonsteroidal anti-inflammatory drugs (NSAIDs) in children. I am, however, concerned by the author's statement that NSAIDs can be given in combination with corticosteroids to pediatric patients with rheumatic diseases. Gastrointestinal damage, including ulcers of the stomach and duodenum, has been noted significantly more frequently in adult users of NSAIDs than in nonusers.2 This may be less common in children. However, adults who use both NSAIDs and corticosteroids have an even greater risk (4.4) of developing peptic ulcer disease.3 The latter study found that concurrent use of corticosteroids and NSAIDs led to a "risk for peptic ulcer disease that was 15 times greater than that of nonusers of either drug."3 Based on the aforementioned data in adults, I think that it is prudent to recommend that NSAIDs not References 1. Lindsley CB. Uses of nonsteroidal antiinflammatory drugs in pediatrics . AJDC . 1993; 147:229-236. 2. Allison MC, Howatson AG, Torrance CJ, Lee FD, Russell RI. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs . N Engl J Med . 1992;327:749-754.Crossref 3. Piper JM, Ray WA, Daugherty JR, Griffin MR. Corticosteroid use and peptic ulcer disease: role of nonsteroidal anti-inflammatory drugs . Ann Intern Med . 1991;114:735-740.Crossref 4. Mulberg AE, Linz C, Bern E, Tucker L, Verhave M, Grand RJ. Identification of nonsteroidal antiinflammatory drug-induced gastroduodenal injury in children with juvenile rheumatoid arthritis . J Pediatr . 1993;122:647-649.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Nonsteroidal Anti-inflammatory Drugs and Gastrointestinal Injury in Children

Nonsteroidal Anti-inflammatory Drugs and Gastrointestinal Injury in Children

Abstract

Abstract Sir.—I read with interest the timely article by Lindsley1 published in the February 1993 issue of AJDC on nonsteroidal anti-inflammatory drugs (NSAIDs) in children. I am, however, concerned by the author's statement that NSAIDs can be given in combination with corticosteroids to pediatric patients with rheumatic diseases. Gastrointestinal damage, including ulcers of the stomach and duodenum, has been noted significantly more frequently in adult users of NSAIDs than in...
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References (7)

Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1993.02160360022006
Publisher site
See Article on Publisher Site

Abstract

Abstract Sir.—I read with interest the timely article by Lindsley1 published in the February 1993 issue of AJDC on nonsteroidal anti-inflammatory drugs (NSAIDs) in children. I am, however, concerned by the author's statement that NSAIDs can be given in combination with corticosteroids to pediatric patients with rheumatic diseases. Gastrointestinal damage, including ulcers of the stomach and duodenum, has been noted significantly more frequently in adult users of NSAIDs than in nonusers.2 This may be less common in children. However, adults who use both NSAIDs and corticosteroids have an even greater risk (4.4) of developing peptic ulcer disease.3 The latter study found that concurrent use of corticosteroids and NSAIDs led to a "risk for peptic ulcer disease that was 15 times greater than that of nonusers of either drug."3 Based on the aforementioned data in adults, I think that it is prudent to recommend that NSAIDs not References 1. Lindsley CB. Uses of nonsteroidal antiinflammatory drugs in pediatrics . AJDC . 1993; 147:229-236. 2. Allison MC, Howatson AG, Torrance CJ, Lee FD, Russell RI. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs . N Engl J Med . 1992;327:749-754.Crossref 3. Piper JM, Ray WA, Daugherty JR, Griffin MR. Corticosteroid use and peptic ulcer disease: role of nonsteroidal anti-inflammatory drugs . Ann Intern Med . 1991;114:735-740.Crossref 4. Mulberg AE, Linz C, Bern E, Tucker L, Verhave M, Grand RJ. Identification of nonsteroidal antiinflammatory drug-induced gastroduodenal injury in children with juvenile rheumatoid arthritis . J Pediatr . 1993;122:647-649.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Dec 1, 1993

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