Small risk ratios may have strong public health impact

doi:10.1136/bmj.327.7422.1050-c

BMJ 2003;327:1050-1051 (1 November), doi:10.1136/bmj.327.7422.1050-c

Letter

Small risk ratios may have strong public health impact

The first 150 words of the full text of this article appear below.

EDITOR—Traversa et al studied the hepatoxicity of nimesulideand other nonsteroidal anti-inflammatory drugs (NSAIDs).¹ Nimesulidemay arguably have a small risk of the more severe hepatic injurieswith an odds ratio of 1.9 (95% confidence interval 1.1 to 3.81).Since the drug is widely used in Italy the population attributablerisk could account for a number of avoidable cases.²

The characteristics of users of the different NSAIDs were assumedto be similar on the basis of the numbers of packets per prescription.If, rather than the number of packets, the number of defineddaily doses per person had been used—a more reliable approach—theconclusion would have been different since the mean number ofdefined daily doses per user of nimesulide and NSAIDs were 50.9and 73.2, respectively.

A substantial proportion of nimesulide induced hepatotoxicityoccurred after a comparatively long time of exposure. In Spainfive of the 11 . . . [Full text of this article]

Alfonso Carvajal, professor of pharmacology

Instituto de Farmacoepidemiología, Ramán y Cajal, 7, E-47005 Valladolid, Spain carvajal@ife.uva.es

Miguel Angel Maciá, clinical pharmacologist

Pharmacovigilance Centre of Castilla-La Mancha, Toledo, Spain

Javier García del Pozo, pharmacist, Francisco de Abajo, head

Spanish Medicines Agency, Madrid, Spain

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Cohort study of hepatotoxicity associated with nimesulide and other non-steroidal anti-inflammatory drugs: Giuseppe Traversa, Clara Bianchi, Roberto Da Cas, Iosief Abraha, Francesca Menniti-Ippolito, and Mauro Venegoni
BMJ 2003 327: 18-22. [Abstract] [Full Text] [PDF]