{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T17:56:15Z","timestamp":1761933375759,"version":"build-2065373602"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,1,17]],"date-time":"2012-01-17T00:00:00Z","timestamp":1326758400000},"content-version":"vor","delay-in-days":4583,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[1999,7]]},"abstract":"<jats:p>The risk of a newly diagnosed episode of upper gastrointestinal bleeding, acute liver and renal failure, agranulocytosis, aplastic anemia, severe skin disorders, and anaphylaxis was examined within 30 days after the first prescription for a low dose of diclofenac, naproxen, or ibuprofen in a cohort in the United Kingdom. We identified 22,146 persons using diclofenac (\u2264 75 mg), 46,919 using naproxen (\u2264 750 mg), and 54,830 using ibuprofen (\u2264 1200 mg). Age, gender, and comorbidity were similar in the three cohorts. Overall 64 potential cases were identified, and 20 were confirmed by medical record review. Incidence rates (95% CI) of upper gastrointestinal bleeding\/10,000 people using diclofenac, naproxen, and ibuprofen were 1.8 (0.5\u20104.6), 2.3 (1.2\u20134.2), and 0.4 (0.04\u20131.3), respectively. There were three cases of hepatic injury, one with naproxen and two with ibuprofen. Although low, the incidence of gastrointestinal toxicity remains the main serious adverse event for all study drugs.<\/jats:p>","DOI":"10.1592\/phco.19.10.854.31550","type":"journal-article","created":{"date-parts":[[2004,5,7]],"date-time":"2004-05-07T04:25:07Z","timestamp":1083903907000},"page":"854-859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Low\u2010Dose Diclofenac, Naproxen, and Ibuprofen Cohort Study"],"prefix":"10.1002","volume":"19","author":[{"given":"Susanne","family":"P\u00e9ez\u2010Gutthann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Alberto","family":"Garc\u00eda\u2010Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Duque\u2010Oliart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Varas\u2010Lorenzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,17]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7046.1563"},{"key":"e_1_2_1_3_2","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1046\/j.1365-2125.1998.00701.x","article-title":"Use of the UK General Practice Research database for pharmacoepidemiology","volume":"45","author":"Rodr\u00edguez Garc\u00eda LA","year":"1998","journal-title":"Br J Clin Pharmacol"},{"volume-title":"OXMIS problem codes for primary medical care","year":"1978","author":"Perry J.","key":"e_1_2_1_4_2"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.302.6779.766"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2630010607"},{"volume-title":"Adverse drug reactions. A practical guide to diagnoses and management","year":"1994","author":"B\u00e9nichou CH","key":"e_1_2_1_7_2"},{"volume-title":"Statistical methods in epidemiology","year":"1989","author":"Kahn HA","key":"e_1_2_1_8_2"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(83)90165-0"},{"volume-title":"System for personal computers, release 6.08","year":"1992","author":"SAS Institute","key":"e_1_2_1_10_2"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91843-0"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90185-6"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-114-4-257"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199701000-00003"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332404"},{"volume-title":"The drug etiology of agranulocytosis and aplastic anemia","year":"1991","author":"Kaufman DW","key":"e_1_2_1_16_2"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1996.00440200041005"},{"key":"e_1_2_1_18_2","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.1001\/archinte.1997.00440430108013","article-title":"Gastrointestinal tract bleeding associated with naproxen sodium vs ibuprofen","volume":"157","author":"Strom BL","year":"1997","journal-title":"Arch Intern Med"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199615010-00005"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1993.tb04157.x"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1592%2Fphco.19.10.854.31550","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1592\/phco.19.10.854.31550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:53:49Z","timestamp":1761054829000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1592\/phco.19.10.854.31550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,7]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[1999,7]]}},"alternative-id":["10.1592\/phco.19.10.854.31550"],"URL":"https:\/\/doi.org\/10.1592\/phco.19.10.854.31550","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[1999,7]]},"assertion":[{"value":"2012-01-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}