T1135 The Complementary Role of Impedance Color Contours for Analysis of Impedance-pH Tracings During Esophageal Reflux Monitoring

Abstract

Medical management of adults with osteoarthritis (OA) who require non-steroidal anti-inflammatory drugs (NSAIDs) must be decided after assessing gastrointestinal (GI) and cardiovascular (CV) risks in the individual patient. Aim: To evaluate the gastrointestinal and cardiovascular risk profile of OA patients who require NSAIDs. Methods: We conducted a transversal, multicenter and observational study in consecutive patients with OA who were considered candidates for NSAID treatment and were visited by 374 unselected rheumatologists throughout the National Health System. Patients were classified into three risk groups (low, moderate and high) for their GI and CV characteristics. These were defined attending to the presence of a number of well-established GI risk factors (Lanas & Hunt, Ann Med 2006; 38, 415-28) or to the application of the European SCORE model (Conroy et al. 2003; EurHeart J 24, 987-1003) for assessing the overall risk for cardiovascular disease, respectively. Results: The study sample was composed of 3293 patients; mean age was 64.7±10.9 years, the majority of whom were women (73.2%). The mean time from diagnosis was 5.4 years, with 66.6% of the patients diagnosed with axial OA of the spine and 81.1% with peripheral OA of the hand, hip and knee. Most patients (86.6%) (2880/3248) were at increased GI risk, and a significant number (22.3%) (724/3248) were at high GI risk. The CV risk was high in 44.2% of the patients (1440/3261), moderate in 19.9% (648/3261) and low in 36% (1173/3261). Only 26.4% of those at high CV risk were on ASA, whereas 22.7% of all ASA users (104/457) were taking concomitantly Ibuprofen. Overall, 15.5% (504/3248) of patients presented a very high-risk profile, having both high GI and CV risks. The type of NSAID prescription was similar regardless of the associated GI and CV risk profile. Conclusion: Most patients with osteoarthritis requiring NSAIDs for pain control showed a high prevalence of GI and CV risk factors. Over half of the patients were at either high GI or CV risk or both, such that the prescription of OA treatments should be very carefully considered.