Use of risk medication for stomach ulcers and stomach protection relating to ulcer occurrence after bariatric surgery

B. Sezgi, M. A. Damhof, L. F. Faneyte, J. Van Der Palen, L. L. Krens

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To assess the influence of risk medication and proton pump inhibitor use on ulcer-free survival in patients after bariatric surgery. DESIGN Retrospective cohort study. METHODS By using a retrospective chart review, information was collected about the use of medication among 631 patients who underwent a Roux-and-Y gastric bypass, an omega-loop bypass or received a gastric sleeve. Kaplan-Meier survival estimates were calculated to study the effect of risk medication on the median time to ulcer development after bariatric surgery. The effect of the single and combined use of risk medication with or without proton pump inhibitors was evaluated by Cox proportional hazard models.

RESULTS: The median disease-free survival could not be computed because of the low incidence of ulcers (0.79%). The hazard ratios (HR) for use of any risk medication, NSAIDs, corticosteroids, antiplatelet drugs, anticoagulants and SNRIs were 1.51 (95% confidence interval [CI] 0.17-13.61, p - 0.714), 0.05 (95% CI 0.00- 180,000,000. p 0.761), 0.04 (95% CI 0.00-70,125, p = 0.668). and 4.10 (95% CI 0.68-24.66, p = 0.123), respectively. The hazard ratios for the combinations of NSAIDs with any risk medication or with SNRIs were 3.28 (95% CI 0.36-29.66, p = 0.290) and 7.74 (95% CI 0.86-69.46. p = 0.067) white the hazard ratios for the other combinations could not be calculated. The rare combination of an NSAID, an anticoagulant and an SNRI and the combination of an anticoagulant with an SNRI resulted in a statistically significant higher risk for developing an ulcer (HR 37.52 with 95% CI 4.10-343.19. p = 0.001 and 24.16 with 95% CI 4.03-144.83. p < 0.0001, respectively), despite the use of proton pump inhibitors (HR 37.52 with 95% CI 4.10-343.19. p < 0.001 and 25.45 with 95% CI 4.24-152.70. p = <0.0001. respectively).'

CONCLUSION: Despite the prophylactic use of proton pump inhibitors, we found an association between the development of an ulcer and SNRI use. as well as with the combination of an SNRI and an anticoagulant with or without the use of an NSAID.

Original languageEnglish
Pages (from-to)19-22
Number of pages4
JournalPharmaceutisch weekblad
Volume152
Issue number43
Publication statusPublished - 27 Oct 2017

Fingerprint

Bariatric Surgery
Stomach Ulcer
Ulcer
Stomach
Confidence Intervals
Proton Pump Inhibitors
Non-Steroidal Anti-Inflammatory Agents
Anticoagulants
Gastric Bypass
Survival
Platelet Aggregation Inhibitors
Kaplan-Meier Estimate
Proportional Hazards Models
Disease-Free Survival
Serotonin and Noradrenaline Reuptake Inhibitors
Adrenal Cortex Hormones
Cohort Studies
Retrospective Studies

Cite this

@article{2ddbef19af5b4cbdb09d3ef9e5f5890a,
title = "Use of risk medication for stomach ulcers and stomach protection relating to ulcer occurrence after bariatric surgery",
abstract = "OBJECTIVE: To assess the influence of risk medication and proton pump inhibitor use on ulcer-free survival in patients after bariatric surgery. DESIGN Retrospective cohort study. METHODS By using a retrospective chart review, information was collected about the use of medication among 631 patients who underwent a Roux-and-Y gastric bypass, an omega-loop bypass or received a gastric sleeve. Kaplan-Meier survival estimates were calculated to study the effect of risk medication on the median time to ulcer development after bariatric surgery. The effect of the single and combined use of risk medication with or without proton pump inhibitors was evaluated by Cox proportional hazard models.RESULTS: The median disease-free survival could not be computed because of the low incidence of ulcers (0.79{\%}). The hazard ratios (HR) for use of any risk medication, NSAIDs, corticosteroids, antiplatelet drugs, anticoagulants and SNRIs were 1.51 (95{\%} confidence interval [CI] 0.17-13.61, p - 0.714), 0.05 (95{\%} CI 0.00- 180,000,000. p 0.761), 0.04 (95{\%} CI 0.00-70,125, p = 0.668). and 4.10 (95{\%} CI 0.68-24.66, p = 0.123), respectively. The hazard ratios for the combinations of NSAIDs with any risk medication or with SNRIs were 3.28 (95{\%} CI 0.36-29.66, p = 0.290) and 7.74 (95{\%} CI 0.86-69.46. p = 0.067) white the hazard ratios for the other combinations could not be calculated. The rare combination of an NSAID, an anticoagulant and an SNRI and the combination of an anticoagulant with an SNRI resulted in a statistically significant higher risk for developing an ulcer (HR 37.52 with 95{\%} CI 4.10-343.19. p = 0.001 and 24.16 with 95{\%} CI 4.03-144.83. p < 0.0001, respectively), despite the use of proton pump inhibitors (HR 37.52 with 95{\%} CI 4.10-343.19. p < 0.001 and 25.45 with 95{\%} CI 4.24-152.70. p = <0.0001. respectively).'CONCLUSION: Despite the prophylactic use of proton pump inhibitors, we found an association between the development of an ulcer and SNRI use. as well as with the combination of an SNRI and an anticoagulant with or without the use of an NSAID.",
author = "B. Sezgi and Damhof, {M. A.} and Faneyte, {L. F.} and {Van Der Palen}, J. and Krens, {L. L.}",
year = "2017",
month = "10",
day = "27",
language = "English",
volume = "152",
pages = "19--22",
journal = "Pharmaceutisch weekblad",
issn = "0031-6911",
publisher = "Kon. Ned. Mij. ter Bevordering der Pharmacie (KNMP)",
number = "43",

}

Use of risk medication for stomach ulcers and stomach protection relating to ulcer occurrence after bariatric surgery. / Sezgi, B.; Damhof, M. A.; Faneyte, L. F.; Van Der Palen, J.; Krens, L. L.

In: Pharmaceutisch weekblad, Vol. 152, No. 43, 27.10.2017, p. 19-22.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Use of risk medication for stomach ulcers and stomach protection relating to ulcer occurrence after bariatric surgery

AU - Sezgi, B.

AU - Damhof, M. A.

AU - Faneyte, L. F.

AU - Van Der Palen, J.

AU - Krens, L. L.

PY - 2017/10/27

Y1 - 2017/10/27

N2 - OBJECTIVE: To assess the influence of risk medication and proton pump inhibitor use on ulcer-free survival in patients after bariatric surgery. DESIGN Retrospective cohort study. METHODS By using a retrospective chart review, information was collected about the use of medication among 631 patients who underwent a Roux-and-Y gastric bypass, an omega-loop bypass or received a gastric sleeve. Kaplan-Meier survival estimates were calculated to study the effect of risk medication on the median time to ulcer development after bariatric surgery. The effect of the single and combined use of risk medication with or without proton pump inhibitors was evaluated by Cox proportional hazard models.RESULTS: The median disease-free survival could not be computed because of the low incidence of ulcers (0.79%). The hazard ratios (HR) for use of any risk medication, NSAIDs, corticosteroids, antiplatelet drugs, anticoagulants and SNRIs were 1.51 (95% confidence interval [CI] 0.17-13.61, p - 0.714), 0.05 (95% CI 0.00- 180,000,000. p 0.761), 0.04 (95% CI 0.00-70,125, p = 0.668). and 4.10 (95% CI 0.68-24.66, p = 0.123), respectively. The hazard ratios for the combinations of NSAIDs with any risk medication or with SNRIs were 3.28 (95% CI 0.36-29.66, p = 0.290) and 7.74 (95% CI 0.86-69.46. p = 0.067) white the hazard ratios for the other combinations could not be calculated. The rare combination of an NSAID, an anticoagulant and an SNRI and the combination of an anticoagulant with an SNRI resulted in a statistically significant higher risk for developing an ulcer (HR 37.52 with 95% CI 4.10-343.19. p = 0.001 and 24.16 with 95% CI 4.03-144.83. p < 0.0001, respectively), despite the use of proton pump inhibitors (HR 37.52 with 95% CI 4.10-343.19. p < 0.001 and 25.45 with 95% CI 4.24-152.70. p = <0.0001. respectively).'CONCLUSION: Despite the prophylactic use of proton pump inhibitors, we found an association between the development of an ulcer and SNRI use. as well as with the combination of an SNRI and an anticoagulant with or without the use of an NSAID.

AB - OBJECTIVE: To assess the influence of risk medication and proton pump inhibitor use on ulcer-free survival in patients after bariatric surgery. DESIGN Retrospective cohort study. METHODS By using a retrospective chart review, information was collected about the use of medication among 631 patients who underwent a Roux-and-Y gastric bypass, an omega-loop bypass or received a gastric sleeve. Kaplan-Meier survival estimates were calculated to study the effect of risk medication on the median time to ulcer development after bariatric surgery. The effect of the single and combined use of risk medication with or without proton pump inhibitors was evaluated by Cox proportional hazard models.RESULTS: The median disease-free survival could not be computed because of the low incidence of ulcers (0.79%). The hazard ratios (HR) for use of any risk medication, NSAIDs, corticosteroids, antiplatelet drugs, anticoagulants and SNRIs were 1.51 (95% confidence interval [CI] 0.17-13.61, p - 0.714), 0.05 (95% CI 0.00- 180,000,000. p 0.761), 0.04 (95% CI 0.00-70,125, p = 0.668). and 4.10 (95% CI 0.68-24.66, p = 0.123), respectively. The hazard ratios for the combinations of NSAIDs with any risk medication or with SNRIs were 3.28 (95% CI 0.36-29.66, p = 0.290) and 7.74 (95% CI 0.86-69.46. p = 0.067) white the hazard ratios for the other combinations could not be calculated. The rare combination of an NSAID, an anticoagulant and an SNRI and the combination of an anticoagulant with an SNRI resulted in a statistically significant higher risk for developing an ulcer (HR 37.52 with 95% CI 4.10-343.19. p = 0.001 and 24.16 with 95% CI 4.03-144.83. p < 0.0001, respectively), despite the use of proton pump inhibitors (HR 37.52 with 95% CI 4.10-343.19. p < 0.001 and 25.45 with 95% CI 4.24-152.70. p = <0.0001. respectively).'CONCLUSION: Despite the prophylactic use of proton pump inhibitors, we found an association between the development of an ulcer and SNRI use. as well as with the combination of an SNRI and an anticoagulant with or without the use of an NSAID.

UR - http://www.scopus.com/inward/record.url?scp=85034013610&partnerID=8YFLogxK

M3 - Article

VL - 152

SP - 19

EP - 22

JO - Pharmaceutisch weekblad

JF - Pharmaceutisch weekblad

SN - 0031-6911

IS - 43

ER -