Baseline risk of gastrointestinal disorders among new users of meloxicam, ibuprofen, diclofenac, naproxen and indomethacin

Pharmacoepidemiol Drug Saf. 2000 Mar;9(2):113-7. doi: 10.1002/(SICI)1099-1557(200003/04)9:2<113::AID-PDS478>3.0.CO;2-2.


Meloxicam (Mobic((R))) was introduced in the UK in 1996 as a nonsteroidal anti-inflammatory drug (NSAID). To help evaluate the postmarketing experience with meloxicam in the UK, we used the General Practitioners Research Database (GPRD) to characterize the baseline risk of an upper gastrointestinal (GI) event among new users of meloxicam, ibuprofen, diclofenac, naproxen and indomethacin. We selected for analysis a random sample of 5000 meloxicam users, and 5000 users of each of the comparator NSAIDS except indomethacin, for which we selected 2500 subjects. Comparators were matched to meloxicam subjects on age and sex. We examined for each subject history of certain GI diagnoses and recent use of anti-inflammatory drugs and acid-suppressing drugs. We found that patients receiving meloxicam were at least twice as likely as patients receiving other NSAIDs to have a recent history of GI diagnoses or treatment. We conclude that in the UK meloxicam was used more often than other popular NSAIDs among patients who were at increased baseline risk of GI events. The occurrence of GI events among users of meloxicam, even at a relatively high frequency, therefore, would be expected based solely on this increased baseline risk. Copyright (c) 2000 John Wiley & Sons, Ltd.