Systematic Review of the Relationship Between Nonsteroidal Anti-Inflammatory Medications and Gastrointestinal Complications


Merck and Co., Inc.


Paul Shekelle, MD, PhD (RAND) -- Principal Investigator and Project Director

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat specific rheumatologic conditions and a wide range of pain syndromes. NSAIDS are among the most commonly used medications in the United States. However, NSAIDs can cause a variety of gastrointestinal (GI) side effects.

Merck and Co. has developed an NSAID that may greatly reduce these side effects. The company commissioned this project to produce the best possible estimate of the incidence of GI side effects caused by currently available NSAIDs. The project has two stages:

  • In stage one, we conducted a systematic review of the available evidence and produced a report that estimated the risk of dyspepsia, upper GI ulcer or bleeding, hospitalization, or death due to the use of NSAIDs.
  • In stage two, we will expand upon the initial report to determine what differences, if any, exist among currently available NSAIDs in the risk of these outcomes (i.e., dyspepsia, upper GI ulcer or bleeding, hospitalization, and death).

The final report was completed in 1998.

View Publications View Related Publications

For more information, contact: Paul Shekelle.

A Joint Center of RAND Health and The Agency for Healthcare Research and Quality