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Background: Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and selective COX-2 inhibitors may improve outcomes in breast cancer patients. We investigated the association of aspirin, NSAIDs, and use of selective COX-2 inhibitors with breast cancer recurrence.Methods: We identified incident stage I-III Danish breast cancer patients in the Danish Breast Cancer Cooperative Group registry, who were diagnosed during 1996-2008. Prescriptions for aspirin (>99% low-dose aspirin), NSAIDs, and selective COX-2 inhibitors were ascertained from the National Prescription Registry. Follow-up began on the date of breast cancer primary surgery and continued until the first of recurrence, death, emigration, or 1 January 2013. We used Cox regression models to compute hazard ratios (HR) and corresponding 95% confidence intervals (95% CI) associating prescriptions with recurrence, adjusting for confounders.Results: We identified 34,188 breast cancer patients with 233,130 person-years of follow-up. Median follow-up was 7.1 years; 5,325 patients developed recurrent disease. Use of aspirin, NSAIDs, or selective COX-2 inhibitors was not associated with the rate of recurrence (HRadjusted aspirin = 1.0, 95% CI = 0.90, 1.1; NSAIDs = 0.99, 95% CI = 0.92, 1.1; selective COX-2 inhibitors = 1.1, 95% CI = 0.98, 1.2), relative to nonuse. Prediagnostic use of the exposure drugs was associated with reduced recurrence rates (HRaspirin = 0.92, 95% CI = 0.82, 1.0; HRNSAIDs = 0.86, 95% CI = 0.81, 0.91; HRsCOX-2inhibitors = 0.88, 95% CI = 0.83, 0.95).Conclusions: This prospective cohort study suggests that post diagnostic prescriptions for aspirin, NSAIDs, and selective COX-2 inhibitors have little or no association with the rate of breast cancer recurrence. Prediagnostic use of the drugs was, however, associated with a reduced rate of breast cancer recurrence. [ABSTRACT FROM AUTHOR]

Objectives. Increasing drug expenditures call for better understanding of the reasons behind individual general practitioners'' (GPs'') prescribing decisions. The aim was to analyse associations between GPs'' clinical interests and their preference for new drugs. Design. Historical cohort study using population-based prescription data and data collected by postal questionnaire. Setting and subjects. A total of 68 single-handed GPs in the County of Funen, Denmark. Main outcome measures. GPs'' preferences for two new (2004) drug groups (selective cyclo-oxygenase-2 inhibitors and angiotensin-II antagonists) were analysed. The preference was defined as the percentage of patients receiving a new drug among first-time users of either the new drug or an older alternative. The GPs'' preference proportion was modelled using linear regression analysis. Data from a questionnaire on GPs'' interest in corresponding clinical areas (musculoskeletal diseases and hypertension, respectively), continuing medical education (CME) activities, and previous employment were the independent variables. Results. The adjusted mean difference in preference for new drugs between GPs with high and low interest in each of the two clinical areas was 0.4% (95% CI −−2.0% to 2.8%), and −−2.2% (−−15.0% to 10.7%), respectively. Only current CME activities in the area of hypertension were significantly associated with GPs'' preference for new drugs (adjusted mean difference 17.9% (95% CI 5.8% to 30.0%). Conclusion. No clear association between GPs'' self-rated clinical interest and their prescribing of new drugs was found. [ABSTRACT FROM AUTHOR]

Background Few data exist on the impact of non-steroidal anti-inflammatory drug use on peptic ulcer outcome. Aim To examine the 30-day mortality from peptic ulcer bleeding associated with the use of traditional non-steroidal anti-inflammatory drugs and newer selective cyclo-oxygenase-2 inhibitors. Methods Cohort study of patients with a first hospitalization for peptic ulcer bleeding in three Danish counties between 1991 and 2003. Data on pre-admission non-steroidal anti-inflammatory drug use, use of other ulcer-related drugs and comorbidities were obtained from population-based registries. Follow-up data on mortality were obtained from the Danish Civil Registry System. Results Of 7232 patients hospitalized for peptic ulcer bleeding, 28% were current non-steroidal anti-inflammatory drug users. Thirty-day mortality was 11% overall, and 13% among current non-steroidal anti-inflammatory drug users. Compared with never-use, the adjusted 30-day mortality rate ratios were 1.4 (95% CI: 1.1–1.9) for current use of non-steroidal anti-inflammatory drugs alone and 1.3 (95% CI: 1.0–1.7) for current use combined with other ulcer-related drugs. For users of celecoxib, alone and in combination, adjusted mortality rate ratios were 1.4 (95% CI: 0.5–3.9) and 2.0 (95% CI: 1.2–3.5), and for users of rofecoxib, 1.2 (95% CI: 0.4–3.9) and 0.9 (95% CI: 0.5–1.6). Conclusion Among patients hospitalized with peptic ulcer bleeding, use of non-steroidal anti-inflammatory drugs, including some newer cyclo-oxygenase-2 inhibitors, is associated with increased short-term mortality. [ABSTRACT FROM AUTHOR]