Significance of Risk Factors for Nonsteroidal Anti-Inflammatory Drug-Induced Gastropathy in Patients with Rheumatoid Arthritis

Aim: to determine the frequency of detection of nonsteroidal anti-inflammatory drug-induced (NSAID-induced) gastropathy in patients with rheumatoid arthritis depending on risk factors.

Materials and methods. A total of 97 patients with rheumatoid arthritis were examined. The control group consisted of 35 virtually healthy individuals who did not take NSAIDs and were matched for age and sex with the main group. A questionnaire survey was conducted to evaluate seven risk factors (one point for a positive response). All patients underwent esophagogastroduodenoscopy with the assessment of gastropathy severity using the F.L. Lanza scale for quantitative evaluation of erosive and ulcerative lesion severity.

Results. The analysis showed that the number of patients with rheumatoid arthritis who had no risk factors was small and amounted to 7 individuals (7.2 % of the total number of patients in the group). At the same time, gastropathy was detected in 5 (71.4 %) cases even among these individuals. Gastropathy was detected in 73 (81.1 %) out of 90 patients with ≥ 1 risk factor, but the difference with the group without risk factors was statistically insignificant (χ² = 0.39; p > 0.05; odds ratio (OR) = 1.718; 95% confidence interval (95% CI): 0.307–9.618). In the group of patients with ≥ 2 risk factors, gastropathy was detected in 70 (84.3 %) out of 83 patients; the difference with the group with ≤ 1 risk factor was statistically significant (χ² = 5.62; p < 0.05; OR = 4.038; 95% CI: 1.201–13.581). In patients with ≥ 3 risk factors, gastropathy was detected in 58 (89.2 %) out of 65 cases; the difference with the group with ≤ 2 risk factors was statistically significant (χ² = 9.73; p < 0.05; OR = 4.971; 95% CI: 1.719–14.374).

Conclusions. The calculation of the odds ratio with a 95% confidence interval shows that the absence of risk factors does not exclude the presence of gastropathy in a patient; however, the risk of its development increases statistically significantly with the accumulation of two or more factors.

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