Characterics of exposure to non-steroid anti-inflammatory drugs in European databases.

Vries, F. de, Kieler, H., Dijk, L. van, Svensson, T., Staa, T. van. Characterics of exposure to non-steroid anti-inflammatory drugs in European databases. Pharmacoepidemiology and Drug Safety: 2010, 19(Supp. 1), p. S174-S175. Abstract. 26th International Conference 'Pharmacoepidemiology & Therapeutic Risk Management', 19-22 augustus 2010, Brighton, UK.
Background: A systematic review reported that users of naproxen, ibuprofen and piroxicam did not have an increased risk of myorcardial infarction (MI), whilst users of diclofenac and indomethacin showed significantly increased risk of MI (RRs 1.4 and 1.3). While there may be biological plausible explanations for these findings, it has been reported that some types of NSAIDs may be channeled to different patients. Objectives: To describe exposure characteristics of different types of NSAIDs in various European countries. Methods: We analysed all NSAID prescriptions from the Dutch LINH database (2001–2007), Country of Sweden (2005–2007), and British (1991–2009) and German (1992–2009) IMS Disease Analyser. The total source population consisted of > 25 million patients. Characteristics prior to each NSAID prescription were determined. Results: A total number of 22.5 million prescriptions were identified in a total number of 5.7 million users. Preferred NSAIDs varied across countries. Ibuprofen prescriptions constituted 16% in Sweden and 38% in Germany and naproxen prescriptions 15% in Sweden the Netherlands and 1% in Germany. Prior use of other NSAIDs among celecoxib users varied from 15% in Sweden to 40% in the Netherlands. In contrast to users of either diclofenac, ibuprofen or naproxen those who filled a prescription with indometacin, meloxicam or ketoprofen had more often had 10 or more previous NSAID prescriptions. Conclusions: There was a strong heterogeneity in exposure patterns between different NSAID substances and between countries. (aut. ref.)