与NSAID相比,罗菲科克西布的上部胃肠道不良影响
M J Langman1, D M Jensen, D J Watson
1Department of Medicine, University of Birmingham, England.
与传统的非类固醇抗炎药物 (NSAIDs) 相比,罗菲科西布显著降低了骨关节炎患者上部胃肠道出血 (PUBs) 的发生率. 这种COX-2抑制剂为管理疼痛提供了更安全的替代方案,同时尽量减少严重的胃肠道风险.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 类风湿病学 类风湿病学
背景情况:
- 非类固醇抗炎药物 (NSAID) 诱导的胃肠道 (GI) 毒性影响与循环氧基因酶1 (COX-1) 抑制有关.
- 作为一种选择性COX-2抑制剂的罗菲科西布,与传统的NSAID相比,其上部肠道损伤的可能性较低.
研究的目的:
- 为了比较可能上部消化道出血 (PUBs) 的发病率,在接受罗菲科西布治疗的骨关节炎患者与NSAIDs.
主要方法:
- 分析了8项双盲,随机的2b/3期骨关节炎试验,涉及5435名患者.
- 患者接受了罗菲科克西布 (12.5-50毫克/天) 或NSAIDs (易布洛芬,迪克洛菲纳克或纳布米顿).
- 使用生存分析评估了PUBs的累积发病率,结果由一个盲目的委员会裁决.
主要成果:
- 与NSAIDs (1.8%;P = .046) 相比,rofecoxib (1.3%) 的12个月累计PUB发生率明显较低.
- 在12个月的时间里,罗菲科西布与NSAID相比,PUB的相对风险为0.51.
- 在最初的6个月内,罗菲科克西布的消化不良经历也较低.
结论:
- 在骨关节炎患者中,用罗菲科克西布治疗与潜在上部肠道出血 (PUB) 的发生率显著降低.
- 罗菲科西布代表了更安全的治疗选择,用于骨关节炎的管理,涉及到严重的上部胃肠道并发症.
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