The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Reduced risk of gastrointestinal bleeding associated with eupatilin in aspirin plus acid suppressant users: nationwide population-based study

  • Hyun Seok Lee (Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital) ;
  • Ji Hyung Nam (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Dong Jun Oh (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Yeo Rae Moon (Data Platform Division, KakaoHealthcare Corp.) ;
  • Yun Jeong Lim (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine)
  • Received : 2023.08.04
  • Accepted : 2023.10.19
  • Published : 2024.03.01
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Abstract

Background/Aims: Mucoprotective agents, such as eupatilin, are often prescribed to prevent gastrointestinal (GI) bleeding in addition to an acid suppressant despite the absence of a large-scale study. We evaluated the additional effect of eupatilin on the prevention of GI bleeding in both the upper and lower GI tract in concomitant aspirin and acid suppressant users using the nationwide database of national claims data from the Korean National Health Insurance Service (NHIS). Methods: An aspirin cohort was constructed using the NHIS claims data from 2013 to 2020. Patients who manifested with hematemesis, melena, or hematochezia were considered to have GI bleeding. A Cox proportional hazards regression model was used to determine the risk factors for GI bleeding associated with the concomitant use of GI drugs and other covariates among aspirin users. Results: Overall, a total of 432,208 aspirin users were included. The concurrent use of an acid suppressant and eupatilin (hazard ratio [HR] = 0.85, p = 0.016, vs. acid suppressant only) was a statistically significant preventive factor for GI bleeding. Moreover, a more than 3-month duration (HR = 0.88, p = 0.030) of acid suppressant and eupatilin prescription (vs. acid suppressant only) was a statistically significant preventive factor for GI bleeding. Conclusions: Eupatilin administration for ≥ 3 months showed additional preventive effect on GI bleeding in concomitant aspirin and acid suppressant users. Thus, cotreatment with eupatilin with a duration of 3 months or longer is recommended for reducing GI bleeding among aspirin plus acid suppressant users.

Keywords

Acknowledgement

This study was supported by grants from DONG-A ST pharmaceutical research fund and Dongguk University research fund.

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