NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND NEUTROPENIA

Background: The association between nonsteroidal anti-inflammatory dru gs (NSAIDs) and neutropenia is based primarily on case reports only. M ethods: A population-based, case control study was performed with Medi caid claims data from six states. Cases were defined as patients hospi talized with neutropenia. Four controls per case were randomly chosen, matched for age, sex, state, and year. The frequency of exposure to N SAIDs in the 30 days before hospital admission in the cases was compar ed with the frequency in the identical period in the controls. The dia gnosis of neutropenia was validated by review of medical records. Resu lts: The crude odds ratio for NSAIDs as a class was 3.3 (90% confidenc e interval, 1.6 to 6.6). The multivariate adjusted odds ratio was 4.2 (90% confidence interval, 2.0 to 8.7). No single class of NSAIDs, nor any individual NSAID, was associated with a unique risk, although the data on individual NSAIDs were sparse. Even excluding phenylbutazone a nd indomethacin, an increased risk was observed (3.5 [1.6 to 7.6]). Co nclusions: Neutropenia is associated with the use of NSAIDs. However, given the low incidence of this disease, the additional number of case s of neutropenia caused by the use of NSAIDs is small. These data do n ot support the existence of a risk restricted to selected NSAIDs only.