Abstract

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are important agents used as analgesic and antipyretic in the management of inflammatory conditions and pain control in rheumatoid arthritis (RA). NSAIDs has been considered as one of the main causative factors for peptic ulcer and has been found to increase the risk of upper gastrointestinal tract perforation/bleeding by two to four folds. The current study was performed to investigate the associated risk between NSAIDs and the risk of peptic ulcer disease among patients with arthritis in Saudi Arabia.
Methodology: A cross-sectional study was conducted during the period from February to July 2018, in four rheumatology clinics in four-selected tertiary and specialized hospitals in Saudi Arabia.
Results: Among the total 169 rheumatoid arthritis patients included in the study, 121 of them (82.31%) successfully completed the study of which, 96 (79.3%) patients were included in the final analysis as per the eligibility criteria. Peptic ulcer associated symptoms with NSAID use were assessed. Most of the responders reported epigastric pain or burning pain in the stomach (67.7%) and esophageal pain or heartburn (62.5%). Responders reported the development of increased pain after eating (51%) which was relieved after taking an antacid in 66.6% of the subjects. Hematochezia or blood in stool (12.5%) and hematemesis or vomiting of blood (4.1%) was the least of the reported manifestations.
Conclusion: This study found that patients with rheumatoid arthritis taking NSAIDs were at high risk of developing peptic ulcer disease with persistence of GI symptoms. Use of NSAIDs even for less than six months was associated with gastrointestinal effects.

Key words: NSAID, peptic ulcer, arthritis