Video Experimental Relacionado
Updated: Jul 19, 2026
04:41
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Celecoxib versus diclofenac en el tratamiento a largo plazo de la artritis reumatoide: comparación aleatorizada doble
P Emery1, H Zeidler, T K Kvien
1Department of Rheumatology and Rehabilitation, University of Leeds, UK.
Lancet (London, England)
|December 28, 1999
Resumen
Celecoxib demostró antiinflamatorios y analgésicos comparables al diclofenaco en pacientes con artritis reumatoide. Sin embargo, celecoxib redujo significativamente las úlceras gastrointestinales y los eventos adversos, ofreciendo una mejor tolerabilidad.
Área de la Ciencia:
- Reumatología Reumatología.
- Farmacología Farmacología.
- Gastroenterología y Gastroenterología.
Sus antecedentes:
- Los antiinflamatorios no esteroideos (AINE) pueden causar lesiones gastrointestinales al inhibir la ciclooxigenasa (COX).
- Celecoxib inhibe selectivamente la COX-2, mientras que el diclofenaco inhibe tanto la COX-1 como la COX-2.
- Comprender la seguridad gastrointestinal comparativa de estos AINE es crucial para el manejo a largo plazo de los pacientes.
Objetivo del estudio:
- Para comparar la eficacia, seguridad y tolerabilidad de la terapia a largo plazo con celecoxib frente a la terapia con diclofenaco.
- Evaluar la incidencia de úlceras gastrointestinales y los eventos adversos asociados con cada medicamento.
- Para evaluar los efectos antiinflamatorios y analgésicos en pacientes con artritis reumatoide.
Principales métodos:
- Un ensayo aleatorizado de 24 semanas en el que participaron 655 pacientes adultos con artritis reumatoide.
- Los pacientes recibieron celecoxib 200 mg dos veces al día o diclofenac SR 75 mg dos veces al día.
- La seguridad gastrointestinal se evaluó a través de la endoscopia gastrointestinal superior, con la eficacia y la tolerabilidad monitoreadas durante todo el estudio.
Principales resultados:
- Ambos fármacos proporcionaron beneficios antiinflamatorios y analgésicos similares para la artritis reumatoide.
- Se observaron significativamente menos úlceras gastroduodenales en el grupo de celecoxib (4%) en comparación con el grupo de diclofenaco (15%).
- Los eventos adversos relacionados con el aparato gastrointestinal llevaron a la retirada en el 16% de los pacientes con diclofenaco frente al 6% de los pacientes con celecoxib.
Conclusiones:
- Celecoxib ofrece efectos antiinflamatorios y analgésicos sostenidos comparables al diclofenac.
- El tratamiento con celecoxib se asocia con una menor incidencia de ulceración gastrointestinal superior y eventos adversos.
- Celecoxib demuestra una tolerancia superior para el uso a largo plazo en pacientes con artritis reumatoide en comparación con diclofenac.
Videos de Conceptos Relacionados
01:29Drugs for Treatment of Ulcerative Colitis in IBD
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation.
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
01:09Bioequivalence of Drugs: Drugs with Multiple Indications
The concept of therapeutic equivalence (TE) in drugs with multiple indications is complex. A generic drug may be therapeutically equivalent to a brand-name product for one specific indication, but this doesn't necessarily mean it's equivalent for all other indications. Evidence of TE in one patient group and bioequivalence shown in healthy volunteers can support—but not confirm—TE for other indications. However, definitive proof requires individual clinical studies for each indication due to...