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Kirmizi NI, Aydin V, Akici A. Utilization trend of gastric acid-suppressing agents in relation to analgesics. Pharmacoepidemiol Drug Saf. 2021;doi: 10.1002/pds.5381.
Kirmizi, N. I., Aydin, V., & Akici, A. (2021). Utilization trend of gastric acid-suppressing agents in relation to analgesics. Pharmacoepidemiology and drug safety, . https://doi.org/10.1002/pds.5381
Kirmizi, Neriman Ipek, et al. "Utilization trend of gastric acid-suppressing agents in relation to analgesics." Pharmacoepidemiology and drug safety vol. (2021). doi: https://doi.org/10.1002/pds.5381
Kirmizi NI, Aydin V, Akici A. Utilization trend of gastric acid-suppressing agents in relation to analgesics. Pharmacoepidemiol Drug Saf. 2021 Nov 04; doi: 10.1002/pds.5381. Epub 2021 Nov 04. PMID: 34738287.
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Pharmacoepidemiol Drug Saf. 2021 Nov 04; doi: 10.1002/pds.5381. Epub 2021 Nov 04.

Utilization trend of gastric acid-suppressing agents in relation to analgesics.

Pharmacoepidemiology and drug safety

Neriman Ipek Kirmizi, Volkan Aydin, Ahmet Akici

Affiliations

  1. Department of Medical Pharmacology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
  2. Department of Medical Pharmacology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
  3. Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey.

PMID: 34738287 DOI: 10.1002/pds.5381

Abstract

BACKGROUND: Controversies exist about excessive use of gastric acid-suppressing agents or lack of adequate indications, especially when co-prescribed with analgesics for gastroprotection. We aimed to analyze the nationwide trend of gastric acid-suppressing agents and analgesics.

METHODS: We obtained nationwide consumption data of analgesics (nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, others) and gastric acid-suppressing agents (proton pump inhibitors [PPI] and histamine-2 receptor antagonists [H2RAs]) between years of 2014-2018 from IQVIA Turkey. Drug utilization was measured by defined daily dose (DDD)/1000 inhabitants/day (DID) unit. Drug sales data were further used to test the correlation of PPIs and H2RAs to analgesics.

RESULTS: During the study period, analgesic utilization increased from 65.7 to 67.4 DID. NSAIDs constituted 82.7%-84.9% of all analgesic utilization. The consumption of NSAIDs increased by 3.1%, and the most commonly consumed analgesic was diclofenac (18.5 ± 1.5 DID), constituting 25.4%-29.0% of all analgesics. PPI utilization was found to regularly raise from 52.1 DID in 2014 to 72.0 DID in 2018 with an overall increment of 38.2%. Use of H2RAs was found to increase from 11.4 DID in 2014 to 14.0 DID in 2018. The physician visit-adjusted utilization of both antirheumatic NSAIDs and non-antirheumatic analgesics showed significantly moderate-strong positive correlations with PPIs (r: 0.63, 0.48-0.76 and r: 0.63, 0.47-0.75, respectively) and H2RAs (r: 0.61, 0.44-0.73 and r: 0.57, 0.41-0.71, respectively).

CONCLUSION: The utilization trend exhibited a dramatic increase of the gastric acid-suppressing agents -more pronounced for PPIs, with a modest increase in analgesics. Excessive utilization of PPIs does not seem to imply a tendency toward only NSAID-related gastroprotection.

© 2021 John Wiley & Sons Ltd.

Keywords: analgesics; diclofenac; gastric acid-suppressing agents; pantoprazole; ranitidine; utilization trend

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