Current status of nonsteroidal anti-inflammatory drug (NSAID) use in the United States: risk factors and frequency of complications

Am J Med. 1999 Dec 13;107(6A):3S-8S; discussion 8S-10S. doi: 10.1016/s0002-9343(99)00362-9.


Gastrointestinal (GI) toxicity is a major limiting factor in the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Because of the widespread use of these medications, the morbidity and costs associated with GI complications of NSAID use are significant. On the other hand, the costs of providing prophylactic cotherapy to all patients to prevent NSAID-induced ulcers and bleeding are prohibitive. The presence of specific risk factors (advanced age, prior peptic ulcer disease and bleeding, high NSAID doses and concomitant therapy with corticosteroids or anticoagulants) identifies patients who are most likely to have a GI complication. The recognition of these risks in specific patients may influence therapeutic decisions that could decrease the morbidity and costs of NSAID therapy.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Age Factors
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anticoagulants / adverse effects
  • Dose-Response Relationship, Drug
  • Drug Synergism
  • Gastrointestinal Diseases / chemically induced*
  • Gastrointestinal Diseases / epidemiology*
  • Humans
  • Incidence
  • Peptic Ulcer / complications
  • Risk Factors
  • United States / epidemiology


  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticoagulants