J Rheum Dis 2016; 23(1): 47-54  
Gastrointestinal Risk Factors and Non-steroidal Anti-inflammatory Drugs Use in Rheumatoid Arthritis and Osteoarthritis Patients in Korea
Eun Young Lee 1, Seung-Jae Hong2, Yong-Beom Park3, Kyung-Su Park4, Chan-Bum Choi5, Chang-Keun Lee6, Ran Song7, Yun Jong Lee8, Chang Hee Suh9, Hyun Ah Kim10, Jun Ki Min11, Chong-Hyeon Yoon12, Won Park13, Won Tae Chung14, Geun-Tae Kim15, Jung-Yoon Choe16, Seong Wook Kang17, Yong-Wook Park18, Wan-Hee Yoo19, Sang-Heon Lee20
1Division of Rheumatology, Seoul National University College of Medicine, Seoul, 2Department of Rheumatology, Kyung Hee University Medical Center, Seoul, 3Division of Rheumatology, Severance Hospital, Yonsei University College of Medicine, Seoul, 4Department of Rheumatology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, 5Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, 6Division of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 7Department of Rheumatology, Kyung Hee University Hospital at Gangdong, Seoul, 8Department of Rheumatology, Seoul National University Bundang Hospital, Seongnam, 9Department of Rheumatology, Ajou University Hospital, Suwon, 10Department of Rheumatology, Hallym University Sacred Heart Hospital, Anyang, 11Department of Rheumatology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, 12Department of Rheumatology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, 13Division of Rheumatology, Inha University School of Medicine, Incheon, 14Department of Rheumatology, Dong-A University Hospital, Busan, 15Division of of Rheumatology, Kosin University Gospel Hospital, Busan, 16Division of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, 17Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, 18Department of Rheumatology, Chonnam National University Medical School, Gwangju, 19Division of Rheumatology, Chonbuk National University Medical School, Jeonju, 20Department of Rheumatology, Konkuk University Medical Center, Seoul, Korea
Correspondence to: Sang-Heon Lee
Department of Rheumatology, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-ju, Seoul
05030, Korea. E-mail:shlee@kuh.ac.kr
Received: October 6, 2015; Revised: January 21, 2016; Accepted: January 30, 2016; Published online: February 29, 2016.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. The aim of this study was to examine and compare the gastrointestinal (GI) risk factors and treatment patterns of rheumatoid arthritis (RA) and osteoarthritis (OA) patients in Korea. Methods. This was a cross-sectional, observational study on RA and OA patients taking non-steroidal anti-inflammatory drugs (NSAIDs) for at least 1 month. A total of 1,896 patients (981 RA patients, 915 OA patients) were recruited from 20 university hospitals. Data were collected through medical records and patient surveys. GI risk factors included age, prolonged (over 3 months) or high-dose use of NSAIDs, alcohol drinking, smoking, use of aspirin, anticoagulants or glucocorticoids, comorbidities, and history of Helicobacter pylori infection or other GI complications. Treatment patterns were classified according to groups using, selective cyclooxygenase (COX)-2 inhibitors± gastro-protective agents, non-selective COX-2 inhibitors+proton pump inhibitor, or non-selective COX-2 inhibitors± other gastro-protective agents. Results. GI risk factors were highly present in both RA and OA patients. The proportion of prolonged use of NSAIDs, smoking, and glucocorticoid use were higher in RA patients (p<0.001). The proportion of comorbidities and use of aspirin were higher in OA patients (p<0.001). The remaining GI risk factors were present in similar proportions in both groups. Use of selective COX-2 inhibitors or gastro-protective agents was higher in RA patients. Conclusion. Prolonged use of NSAIDs and concomitant glucocorticoid use were higher in RA patients, while comorbidities and concomitant aspirin use were predominant in OA patients. These results will provide insights for use in development of future guidelines for proper selection of NSAIDs and effective prevention of GI complications in arthritis patients. (J Rheum Dis 2016;23:47-54)
Keywords: Rheumatoid arthritis, Osteoarthritis, Gastrointestinal risk factors, Non-steroidal anti-inflammatory agents

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