ローフェコキシビブの制御された臨床試験における心血管性血栓性イベント
M A Konstam1, M R Weir, A Reicin
1Division of Cardiology, New England Medical Center, Boston, Massachusetts, USA. MKonstam@Lifespan.org
Circulation
|November 7, 2001
まとめ
ロフェコキシブは,プラセボまたはナプロキセン以外のNSAIDと比較して,心血管の血栓性イベントの増加を示さなかった. ナプロクセンは,ナプロクセンの
科学分野:
- 心血管医学は,心血管医学である.
- 薬理学 薬理学とは
- 内科内科は,内科の内科です.
背景:
- 非ステロイド性抗炎症薬 (NSAIDs) とサイクロオキシゲネーゼ (COX) -2 阻害剤は,血小板抑制効果によって異なります.
- この変動は,心血管 (CV) 血栓性イベントのリスクに影響を与える可能性があります.
- 以前の研究では,ロフェコキシブとナプロクセンの間のCVリスクの違いが示唆されていました.
研究 の 目的:
- ローフェコキシブの使用がCVの血栓性イベントの過剰と関連しているかどうかを判断する.
- プラセボと非選択的NSAIDとの間でロフェコキシブのCV血栓事件リスクを比較する.
- ランダム化対照試験から得られた個々の患者のデータを分析する.
主な方法:
- 23件のロフェコキシブ試験 (第IIb-V段階) の個々の患者データの統合分析.
- ロフェコキシブはプラセボ,ナプロクセン,および他の非選択的NSAID (ディクロフェナック,イブプロフェン,ナブメトン) と比較されました.
- 抗血小板研究者のコラボレーションのエンドポイントを使用して,主要なCV血栓性イベントを評価しました.
主要な成果:
- 28,000人以上の患者と14,000人の患者年数を分析した.
- ロフェコキシブはプラセボ (RR 0.84) やナプロキセン以外のNSAID (RR 0.79) と比較して過剰なCVイベントを示さなかった.
- ロフェコキシブはナプロクセン (RR 1.69) と比較して,CVイベントのリスクが高いことを示しました.
結論:
- プラセボまたはナプロクセン以外のNSAIDと比較して,ロフェコキシブで過剰なCVイベントの証拠はありません.
- ロフェコキシブとナプロクセンの間の観察された差異は,ナプロクセンの抗血小板効果による可能性が高い.
- ナプロクセンの抗血小板活性により,心臓血管の保護効果がもたらされる可能性があります.
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