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Major gastrointestinal bleeding in older persons using aspirin—incidence and risk factors
There is a lack of robust data into whether aspirin increases the risk of gastrointestinal (GI) bleeding. Mahady et al (GUT 2020, http://dx.doi.org/10.1136/gutjnl-2020-321585) extracted data from the ASPREE (ASPirin in Reducing Events in the Elderly) randomised controlled trial (n=19 114, age 70 years and over, median follow-up 4.7 years). The endpoint was major bleeding defined as that resulting in transfusion, hospitalisation, surgery or death. Over the study period there were 137 upper GI (89 in aspirin arm, 48 in placebo arm; HR 1.87, 95% CI 1.32 to 2.66, p<0.01) and 127 lower GI bleeds (73 in aspirin arm, 54 in placebo arm; HR 1.36, 95% CI 0.94 to 1.9, p=0.08). Risk factors for bleeding included age, hypertension, smoking, chronic kidney disease, non-steroidal anti-inflammatory use and obesity. The authors concluded that although the overall risk of bleeding on aspirin is 60% higher, the absolute risk is low particularly in the younger patient in the absence of other risk factors.
Efficacy of drugs for functional dyspepsia
Functional dyspepsia is a relapsing and remitting condition affecting between 5% and 10% of people. There are multiple potential treatments although limited data on efficacy. Ford et al (Aliment Pharm Therap 2020, https://doi.org/10.1111/apt.16072 …
Correction notice This article has been corrected since it published Online First. The corresponding email address has been updated.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.