Association of oral anticoagulants and PPI cotherapy with hospitalization for upper GI tract bleeding

New research from the Vanderbilt University School of Medicine looked at whether anticoagulant drug choice and proton pump inhibitor (PPI) cotherapy are associated with risk of upper gastrointestinal tract bleeding.

New research from the Vanderbilt University School of Medicine looked at whether anticoagulant drug choice and proton pump inhibitor (PPI) cotherapy are associated with risk of upper gastrointestinal tract bleeding. The retrospective cohort study included 1.6 million Medicare beneficiaries with 1.7 million new episodes of oral anticoagulant treatment between 2011 and 2015. The adjusted incidence of hospitalization for upper gastrointestinal tract bleeding during 754,389 treatment person–years without PPI cotherapy was 115 per 10,000 person–years. The risk of hospitalization was highest for rivaroxaban and lowest for apixaban. When PPI therapy was added to anticoagulant treatment, the risk for hospitalization was lower overall and for each anticoagulant (apixaban, dabigatran, rivaroxaban, and warfarin). "These findings may inform assessment of risks and benefits when choosing anticoagulant agents," the authors conclude.