{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:32:11Z","timestamp":1791232331499,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T00:00:00Z","timestamp":1522886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009560","name":"American Gastroenterological Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009560","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK099681"],"award-info":[{"award-number":["K23 DK099681"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unlike acetaminophen, nonsteroidal anti\u2010inflammatory drugs (NSAIDs) have generally been thought to be associated with increased risk of IBD exacerbation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To carry out a systematic review and meta\u2010analysis of previous studies examining the association between acetaminophen and NSAIDs including cyclooxygenase (COX\u20102) inhibitors use, and risk of Crohn's disease (CD) and ulcerative colitis (UC) exacerbation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified published manuscripts and abstracts through 1 March 2017 by systematic search of Medline, Embase, Cochrane and other trial registries. Quality assessment was done using Newcastle\u2010Ottawa scale and random\u2010effect meta\u2010analysis using pooled relative risks (RRs) and 95% CIs were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen publications between years 1983 and 2016 were identified. For the meta\u2010analysis, pooled RRs of disease exacerbation with NSAIDs use were (1.42, 95% CI, 0.65\u20103.09),\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>\u00a0=\u00a0<\/jats:italic>\n                      60.3% for CD, and (1.52, 95% CI, 0.87\u20102.63),\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>\u00a0=\u00a0<\/jats:italic>\n                      56.1% for UC. The corresponding values for acetaminophen use were (1.40, 95% CI, 0.96\u20102.04),\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>\u00a0=\u00a0<\/jats:italic>\n                      45.6% for UC, and (1.56, 95% CI, 1.22\u20101.99),\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic>\u00a0=\u00a0<\/jats:italic>\n                      0.0% for IBD. Sensitivity analyses limited to studies with low risk of bias showed a significantly increased risk of CD exacerbation (1.53, 95% CI, 1.08\u20102.16) but not UC (0.94, 95% CI, 0.36\u20102.42) with NSAIDs use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Contrary to generally accepted belief, we did not find a consistent association between NSAIDs use and risk of CD and UC exacerbation. There was also no consistent evidence for association with acetaminophen although further studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.14606","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T05:15:53Z","timestamp":1522991753000},"page":"1428-1439","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":108,"title":["Systematic review with meta\u2010analysis: association between acetaminophen and nonsteroidal anti\u2010inflammatory drugs (\n                    <scp>NSAID<\/scp>\n                    s) and risk of Crohn's disease and ulcerative colitis exacerbation"],"prefix":"10.1111","volume":"47","author":[{"given":"O. O.","family":"Moninuola","sequence":"first","affiliation":[{"name":"Harvard University T. H. 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