连续同时处方雷巴米皮德可预防上部胃肠道出血在治疗骨科疾病时使用NSAID:使用LIFE研究数据库进行嵌套病例对照研究
Satoshi Yamate1, Chieko Ishiguro2, Haruhisa Fukuda3,4
1Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
PloS one
|June 11, 2024
概括
连续使用雷巴米皮德显著降低了新的非类固醇抗炎药物 (NSAID) 用户上部胃肠道出血的风险. 然而,不规则的使用增加了这种风险,强调了一致的联合处方的重要性.
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.
- 临床研究 临床研究
背景情况:
- 在日本,雷巴米皮德经常与NSAID联合处方.
- 这项研究评估了rebamipide在新使用NSAID的患者中预防上部胃肠道出血 (UGIB) 的疗效.
- 专注于没有NSAID-的风险因素的患者,不包括年龄.
研究的目的:
- 评估rebamipide在预防NSAID诱导的上部胃肠道出血方面的有效性.
- 为了比较与连续,不规则和没有rebamipide联合处方相关的风险.
主要方法:
- 嵌套病例控制研究利用日本医疗索赔数据 (166万居民).
- 包括新的NSAID用于骨关节炎或腰部疼痛的使用者,不包括特定的风险因素.
- 通过UGIB的胃镜确定病例;对照对性别,年龄,随访,NSAID类型/剂量进行匹配. 分析了使用条件逻辑回归的rebamipide暴露 (非用户,连续用户,不规则用户).
主要成果:
- 在67,561名符合条件的个人中发现了215例病例和1,516例对照.
- 与非使用者相比,连续使用rebamipide的几率比率 (OR) 为0.65 (95% CI:0.44-0.96).
- 不规则的雷巴米皮德使用表明OR为2.57 (95%CI:1.73 - 3.81) 与非使用者相比.
结论:
- 连续联合处方的rebamipide显著降低了新的NSAID用户的UGIB风险.
- 这种保护作用在患有骨关节炎或腰部疼痛的亚洲队列中观察到,不包括年龄作为唯一的风险因素.
- 不定期使用雷巴米皮德与UGIB的风险增加有关.
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