NONSTEROIDAL ANTIINFLAMMATORY DRUG-USE AND GALLSTONE DISEASE PREVALENCE - A CASE-CONTROL STUDY

Objectives: Conflicting results on the relationship between gallstone disease and the use of nonsteroidal antiinflammatory drugs (NSAIDs) ha ve been reported, but studies on the effect of NSAID use in population s not selected on the basis of a high risk for gallstone development a re still lacking. Methods: We conducted a case-control study involving 216 patients, regular NSAID users (43 men and 173 women) consecutivel y admitted to a rheumatology department, suffering from rheumatoid art hritis (n = 147), osteoarthritis (n = 49), and ankylosing spondylitis (n = 20). Two-hundred sixteen patients who were not NSAID users, match ed for gender, age, and body mass index, consecutively admitted to a m edical department for various medical pathologies, acted as a control group. All patients underwent upper abdomen ultrasonography. Results: The overall prevalence of gallstones was similar in the two groups: 24 .0% in NSAID users (15.7% actual stones and 8.3% previous cholecystect omy) and 21.3% in controls (13.9% gallstones and 7.4% cholecystectomy) . The prevalence of gallstone disease was significantly higher in wome n than in men, and the mean age was higher in gallstone patients than in gallstone-free patients, in both groups. No significant differences in type and duration of arthritis condition, type and dose of NSAID t aken, and duration of treatment between gallstone patients and gallsto ne-free patients were found. On logistic regression analysis only fema le gender, aging, and family history of gallstone disease were signifi cantly associated with the presence of gallstones, whereas no relation ship between NSAID use and gallstone disease was found. Conclusions: C hronic NSAID ingestion does not seem to prevent gallstones in arthriti s patients; in these patients gallstone disease is associated with cla ssic risk factors (female gender and age). (Am J Gastroenterol 1998;93 : 1420-1424. (C) 1998 by Am. Cell. of Gastroenterology).