Guo, C-G;
Cheung, KS;
Zhang, F;
Chan, EW;
Chen, L;
Wong, ICK;
Leung, WK;
(2019)
Risks of hospitalization for upper gastrointestinal bleeding in selective serotonin reuptake inhibitors users after Helicobacter pylori eradication therapy: a propensity score matching analysis.
Alimentary Pharmacology and Therapeutics
, 50
(9)
pp. 1001-1008.
10.1111/apt.15507.
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Abstract
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for depression but there is a concern about the risk of upper gastrointestinal bleeding (UGIB). Past studies, however, are largely confounded by the presence of Helicobacter pylori (HP). AIM: To evaluate the UGIB risk of SSRI users after treatment for HP. METHODS: This was a propensity score (PS) matched cohort study with patients who used SSRI after receiving HP eradication therapy from the Hong Kong territory-wide healthcare database. The primary outcome was hospitalisation for nonvariceal UGIB. PS matching analysis with a ratio of 1:2 plus Cox regression model was used to compute the hazards ratios (HR) and 95% CI of UGIB risk. RESULTS: In this study, 3358 SSRI users and 57 906 non-users were included. The median follow-up duration was 7.74 (interquartile range 5.32-10.42) years. The crude incidence of hospitalisation for UGIB was 3.98 (95% CI 3.80-4.16) per 1000 person-years. In the PS matching analysis of 3358 SSRI users with 6716 non-users, SSRI was associated with a higher risk of UGIB compared to non-users (HR 1.95, 95% CI 1.41-2.70). This result was consistent in sensitivity analysis with 1:1 PS matching (HR 2.13, 95% CI 1.50-3.02) and multivariable analysis with 1-month intervals (HR 1.81, 95% CI 1.34-2.45) or 3-month intervals (HR 1.61, 95% CI 1.20-2.17). After stratifying by age, the increased risk of SSRI was only significant among patients >50 years. CONCLUSION: SSRI users have a higher risk of hospitalisation for nonvariceal UGIB after treatment for HP, particularly among older patients.
| Type: | Article |
|---|---|
| Title: | Risks of hospitalization for upper gastrointestinal bleeding in selective serotonin reuptake inhibitors users after Helicobacter pylori eradication therapy: a propensity score matching analysis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/apt.15507 |
| Publisher version: | https://doi.org/10.1111/apt.15507 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | upper gastrointestinal bleeding, selective serotonin reuptake inhibitors, Helicobacter pylori eradication |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10083422 |
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