Document Detail


An approximate Bayesian risk-analysis for the gastro-intestinal safety of ibuprofen.
MedLine Citation:
PMID:  12512246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Although several studies on ibuprofen and its gastro-intestinal (GI) risk have been reported, the dose-response relationship was not clear due to the lack of information regarding high-dose exposure. Analysis using Bayesian methods is appropriate whenever data are sparse, although such methods are not easily implemented. METHODS: A retrospective cohort study to assess this dose-response relationship was carried out using a record linkage database. A Bayesian risk-analysis was conducted using the Bayesian bootstrap approximation. Risks of GI events at different dose levels were compared using the posterior distributions and the number of events predicted to occur in the future was estimated. Risk factors such as age, gender and co-morbidity were adjusted for in the analysis. This approximation was compared with the full Bayesian approach using the usual but more computer-intensive tool of Markov Chain Monte Carlo simulation. RESULTS: There were 1, 5 and 10 complicated GI events during exposure to high, medium and low dose ibuprofen with 0.2, 1.8 and 7.0 thousand person-years (PY) exposure, respectively. After adjusting for other risk factors the relative risks of high versus low and medium versus low doses were 6.3 (95% CI = 0.21, 24.17) and 2.5 (95% CI = 0.71, 5.85), respectively. Using the approximate Bayesian method prediction of the number of events in a population of females aged 50-59 with no previous medical problems with 1000 PY drug exposure showed that the estimated probability of having more than five events was 0.048 for the medium-dose group and 0.14 for the high-dose group. CONCLUSIONS: High dose ibuprofen appears to have a considerably greater risk of having a larger number of adverse GI events than a medium dose. The approximate Bayesian bootstrap method was demonstrated to be a robust and easily implemented alternative to the full Bayesian approach to risk analysis whenever data are sparse.
Authors:
Jixian Wang; Peter T Donnan; Thomas M MacDonald
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pharmacoepidemiology and drug safety     Volume:  11     ISSN:  1053-8569     ISO Abbreviation:  Pharmacoepidemiol Drug Saf     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-01-06     Completed Date:  2003-09-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9208369     Medline TA:  Pharmacoepidemiol Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  695-701     Citation Subset:  IM    
Affiliation:
Medicines Monitoring Unit, Department of Pharmacology and Therapeutics, University of Dundee, Dundee DD1 9SY, Scotland.
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
Bayes Theorem
Cohort Studies
Digestive System / drug effects*
Dose-Response Relationship, Drug
Female
Humans
Ibuprofen / adverse effects*
Male
Retrospective Studies
Scotland
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 15687-27-1/Ibuprofen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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