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切莱可西布与迪克洛芬雅在长期治疗类风湿性关节炎:随机双盲比较
P Emery1, H Zeidler, T K Kvien
1Department of Rheumatology and Rehabilitation, University of Leeds, UK.
Lancet (London, England)
|December 28, 1999
概括
在类风湿性关节炎患者中,切莱科西布的抗炎和缓解疼痛效果与迪克洛芬雅克相当. 然而,赛莱科克西布显著减少了胃肠道和不良事件,提供了更好的耐受性.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 非类固醇抗炎药物 (NSAIDs) 通过抑制循环氧化酶 (COX) 可以导致胃肠道损伤.
- 赛莱科克西布选择性地抑制COX-2,而迪克洛菲纳克则抑制COX-1和COX-2.
- 了解这些NSAIDs的比较胃肠道安全性对于长期患者管理至关重要.
研究的目的:
- 为了比较长期使用赛莱科克西布治疗的疗效,安全性和耐受性与迪克洛芬雅克治疗.
- 评估胃肠道的发生率和与每个药物相关的不良事件.
- 评估类风湿性关节炎患者的抗炎和止痛作用.
主要方法:
- 这是一项为期24周的随机试验,涉及655名成年类风湿性关节炎患者.
- 患者每天两次服用200毫克的赛莱科西布或每天两次服用75毫克的迪克洛菲纳克.
- 胃肠道安全性通过上胃肠道内镜进行评估,在整个研究期间监测有效性和耐受性.
主要成果:
- 这两种药物在类风湿性关节炎中提供了类似的抗炎和止痛效果.
- 与迪克洛菲纳克 (15%) 组相比,在赛莱科西布组 (4%) 观察到的胃口的数量显著减少.
- 与胃肠道相关的不良事件导致16%的迪克洛芬雅克患者退出治疗,而塞莱科克西布患者的这一比例为6%.
结论:
- 切莱科克西布具有与狄克洛芬雅克相当的持续的抗炎和止痛作用.
- 切莱科克西布治疗与上部胃肠道和不良事件的发病率较低有关.
- 切莱科克西布在类风湿性关节炎患者的长期使用中表现出较高的耐受性,与迪克洛芬雅克相比.
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