控制的,临床试验中的心血管血栓事件rofecoxib的rofecoxib
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
概括
与安慰剂或非纳普罗森NSAID相比,罗菲科克西布没有显示心血管血栓事件的增加. 纳普洛克森 (Naproxen) 是一种药物.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学 是一个学科.
- 内部医学 内部医学
背景情况:
- 非类固醇抗炎药物 (NSAID) 和循环氧化酶 (COX) -2 抑制剂在血小板抑制作用方面有所不同.
- 这种变化可能会影响心血管 (CV) 血栓事件的风险.
- 之前的研究表明,罗菲可西布和纳普罗森之间心血管风险存在差异.
研究的目的:
- 为了确定使用罗菲科克西布是否与心血管血栓事件的过度发生有关.
- 为了比较rofecoxib的CV血栓事件风险与安慰剂和非选择性NSAIDs.
- 分析随机对照试验中的个体患者数据.
主要方法:
- 综合分析来自23个rofecoxib研究 (IIb-V期) 的个体患者数据.
- 罗菲科西布与安慰剂,纳普罗森和其他非选择性NSAIDs (迪克洛菲纳克,布洛芬,纳布米顿) 相比.
- 使用抗血小板试验者协作终点评估主要心血管血栓事件.
主要成果:
- 分析了超过28000名患者和14000名患者年.
- 罗菲科克西布与安慰剂 (RR 0.84) 或非纳普罗森NSAIDs (RR 0.79) 相比,没有显示过多的CV事件.
- 罗菲科克西布显示心血管事件的风险高于纳普罗森 (RR 1.69).
结论:
- 没有证据表明与安慰剂或非纳普罗森NSAIDs相比,罗菲科克西布的CV事件过多.
- 罗菲科西布和纳普罗森之间观察到的差异很可能是由于纳普罗森的抗血小板作用.
- 纳普罗的抗血小板活性可能会产生心血管保护的益处.
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