特拉马多尔与骨关节炎患者全因死亡率的相关性
Chao Zeng1,2, Maureen Dubreuil3,4, Marc R LaRochelle5
1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
JAMA
|March 13, 2019
概括
与NSAID相比,对骨关节炎的特拉马多尔处方与死亡率的增加有关,但与可代因无关. 需要进一步的研究来确认这种关联是否具有因果关系.
科学领域:
- 老年学
- 药理学
- 流行病学
背景情况:
- 指导方针推用于膝关节骨关节炎,有些人将其作为NSAIDs的第一线治疗.
- 需要有效的疼痛管理策略.
研究的目的:
- 在骨关节炎患者中研究特拉马多尔处方与全因死亡率之间的关联.
- 将特拉马多尔与其他常用止痛药的死亡风险进行比较.
主要方法:
- 一个连续的,与倾向分数匹配的队列研究利用了2000-2016年英国的一般实践数据.
- 包括50岁以上的患有骨关节炎的患者,将特拉马多尔与处方纳普罗森,迪克洛芬雅克,切莱可西布,埃托利可西布或编解素的患者进行比较.
主要成果:
- 与纳普罗森,迪克洛芬纳克,切莱可西布和埃托利可西布相比,特拉马多尔与1年全因死亡率显著上升.
- 在特拉马多和可代因使用者之间没有发现显著的死亡率差异.
- 这项研究包括88,902名患者,平均年龄为70. 1岁.
结论:
- 与NSAID相比,在患有骨关节炎的老年人中,最初的特拉马多尔处方与死亡率的增加有关.
- 观察到的关联可能受到混因素的影响,需要进一步调查因果关系.
- 研究结果表明,在治疗关节炎时,需要仔细考虑特拉马多尔的风险与益处.
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