88 CHAPTER 2.2 Table SI1.1. Continued. STOPP Action Clarity rating Condition Clarity rating Explanation Clarity rating H4 Long-term corticosteroids (>3 months) 83% as monotherapy for rheumatoid arthrtitis 67% (risk of systemic corticosteroid side-effects). 58% H5 Corticosteroids (other than periodic intra-articular injections for monoarticular pain) 83% for osteoarthritis 100% (risk of systemic corticosteroid side-effects). 58% H6 Long-term NSAID or colchicine (>3 months) 67% for chronic treatment of gout where there is no contraindication to a xanthine-oxidase inhibitor e.g. allopurinol, febuxostat 50% (xanthine-oxidase inhibitors are first choice prophylactic drugs in gout). 33% H7 COX-2 selective NSAIDs 83% with concurrent cardiovascular disease 42% (increased risk of myocardial infarction and stroke). 75% H8 NSAID 58% with concurrent corticosteroids without PPI prophylaxis 58% (increased risk of peptic ulcer disease). 75% H9 Oral bisphosphonates 75% in patients with a current or recent history of upper gastrointestinal disease i.e. dysphagia, oesophagitis, gastritis, duodenitis, or peptic ulcer disease, or upper gastrointestinal bleeding 92% (risk of relapse/exacerbation of oesophagitis, oesophageal ulcer, oesophageal stricture) 83%
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