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• Galileo

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• Comparative gastro-intestinal toxicity of
  individual nonsteroidal anti-inflammatory drugs
  a meta-analysis of 12 endoscopic studies
  involving 1725 rheumatic patients.
• L. PUCCETTI, R. PUCCETTI, N. SCORPINITI,
  M.L. CIOMPI

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• Inclusion criteria

OA or RA patients active treatments for at least
4 weeks standard doses native molecules detailed
endoscopic data, both basal and final
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• Key outcome parameter

CSLs, found by endoscopy, such as ulcers (any
size or complication) gt 10 erosions or
petechiae submucosal haemorrhages oozing or
intraluminar bleeding
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• YOLLS per fatal event

whole Italian population 9.86 yolls people gt 60
years old 8.34 yolls people gt 65 years old 7,76
yolls
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• Cases considered in the meta-analysis

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Not survival
(0.10)
Surgery
(0.167)
Hospital
Survival
(0.033)
(0.90)
Medical
Uncomplicated
(0.833)
(0.839)
CSL
Ambulatory
Not survival
(0.967)
Surgery
(0.10)
(, variable)
(0.167)
Complicated
Hospital
NSAiD
(0.161)
(1.0)
Survival
No CSL
(0.90)
Medical
(, variable)
(0.833)
Fig. 1 Decision tree used to estimate the
consequences of NSAiD-induced CSLs.
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Table III - CSLs, FEs and yolls estimated to be
induced in 100.000
courses by any individual NSAiD.
Legenda CSLs clinicant significant lesions FEs
fatal events
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Table IV - Fatal events potentially avoidable in
100.000 courses by
substituting a given NSAiD with the less toxic
one on the g-i tract.
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Table V - Years of life potentially saveable in
100.000 courses
administered to patients gt 60 years old, by
substituting a given NSAiD
with the others progressively safer on the g-i
tract.
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• CONLCUSIONS

NSAID-induced G-I toxicity decreases life
expectancy Ketoprofen is the most toxic on the
G-I tract Tenoxicam is the less toxic on the G-I
tract No significant differences among the other
NSAIDs Different G-I toxicity reflects relevant
differences in terms of costs and YOLLS