Interní Med. 2002; 4(7): 336-340

Současný pohled na účinnou a bezpečnou léčbu nesteroidními antirevmatiky

MUDr. Pavel Horák CSc
III. interní klinika FN a LF UP Olomouc

Keywords: nonsteroidal anti-inflammatory drugs, NSAID gastropathy, COX2 selectivity.

Published: December 31, 2002  Show citation

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Horák P. Současný pohled na účinnou a bezpečnou léčbu nesteroidními antirevmatiky. Interní Med. 2002;4(7):336-340.

Nesteroidní antirevmatika představují jednu z nejčastěji používaných lékových skupin. Jejich podání je však v nezanedbatelném procentu nemocných spojeno s projevy gastrointestinálních vedlejších účinků, které mohou v některých případech ohrozit i život. Článek podává přehled skupiny takzvaných COX2 selektivních antirevmatik, která oproti tradičním mají lepší profil gastrointestinální snášenlivosti. Jsou diskutovány i další možnosti zabránění gastropatie stejně jako některé aspekty účelné farmakoterapie nesteroidními antirevmatiky.

Current view on the efficient and safe therapy with nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatories represent one of the most frequently prescribed group of drugs. Their administration is, however, associated in quite large number of patients with signs of gastrointestinal side effects, that can sometimes threaten even a patient´s life. The article delivers a review of a group of COX2 selective antirheumatics, which possess a better profile of gastrointestinal tolerance compared to conventional NSAIDs. Other possibilities how to avoid gastropathy and some aspects of reasonable NSAIDs therapy are discussed as well.

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    References

    1. Aisen PS. Inflammation and Alzheimer Disease. Mol Chem Neuropathol 1996; 28: 83-88. Go to original source... Go to PubMed...
    2. Bacon PA. An overview of the efficacy of etodolac in arthritic disorders. Eur J Rheumatol Inflamm 1990; 17: 5-18.
    3. Bennet A, Berti F, Ferreira SH. Nimesulid: a multifactorial therapeutic approach to the inflammatory process? A 7-year clinical experience: Drugs 1993; 46: (Suppl. 1) 1-283. Go to original source...
    4. Bensen WG, Fiechtner JJ, McMillen JI. Treatment of osteoarthritis with celecoxib a cyclooxygenase-2 inhibitor: a randomised controlled trial. Mayo Clin Proc 1999; 74: 1095-1105. Go to original source... Go to PubMed...
    5. Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. N Eng J Med 2000; 343: 1520-1528. Go to original source... Go to PubMed...
    6. Cannon GW, Caldwell JR, Holt O, et al. Rofecoxib, a specific inhibitor of cyclooxygenase-2, with clinical efficacy comparable with that of diclofenac sodium: results of a one-year, randomized, clinical trial in patients with osteoarthritis of the knee and hip. Rofecoxib Phase III Protocol 035 Study Group, Arthritis Rheum 2000; 43: 978-987. Go to original source...
    7. Dequeker J, Hawkey C, Kahan A, et al. Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor- meloxicam, compared with piroxicam: results of the Safety and efficacy Large-scale Evaluation of COXinhibiting Therapies (SELECT) trial in osteoarthritis. Br J Rheumatol 1998; 37: 946-951. Go to original source... Go to PubMed...
    8. Ehrich EW, Schnitzer TJ, McIlwain H, et al. Effect of specific COX2 inhibition in osteoarthritis of the knee: a 6 week double blind, placebo controlled pilot study of rofecoxib. Rofecoxib Osteoarthritis Pilot Study Group. J Rheumatol 1999; 26: 2438-2447. Go to PubMed...
    9. Emmery P, Zeidler H, Kvien TK, Guslandi M, et al. Celecoxib versus diclofenac in long-term management of rheumatoid arhtritis: randomised double-blind comparison. Lancet 1999; 364: 2106-2111. Go to original source... Go to PubMed...
    10. Gabriel SE, Crowson CS, O'Fall. Comorbidity in arthritis. Journal of Rheumatology 1999; 26: 2475-2479. Go to PubMed...
    11. Hawkey C, Kahan A, Steinbrück K, et al. Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br J Rheumatol 1998; 37: 937-945. Go to original source... Go to PubMed...
    12. Hawkey C, Laine L, Simon T, et al. Comparison of the effect of rofecoxib (a cyclooxygenase 2 inhibitor), ibuprofen, and placebo on the gastroduodenal mucosa of patients with osteoarthritis: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2000; 43: 370-307. Go to original source...
    13. Laine L, Harper S, Simon T, et al. A randomized trial comparing the effect of rofecoxib, a cyclooxygenase 2 specific inhibitor, with that of ibuprofen on the gastroduodenal mucosa of patients with osteoarthritis. Rofecoxib Osteoarthritis Endoscopy Study Group. Gastroenterology 1999; 117: 776-783. Go to original source... Go to PubMed...
    14. Langman MJ, Jensen DM, Watson DJ, et al. Adverse upper gastrointestinal effects of rofecoxib compared with NSAIDs. J Am Med Assoc 1999; 282: 1929-1933. Go to original source... Go to PubMed...
    15. Lefkowith JL, Wendt HL, Burr AM, et al. Efficacy of celecoxib, a COX2 specific inhibitor, in osteoarthritis of the hip. Ann Rheum Dis 1999; 42 (Suppl): 144.
    16. Pavelka K, Sainerová A. Léčebné standardy. Osteoarhtóza váhonosných kloubů. Čes Revmatol 1999; 7 (Suppl. 1): 12-16. Go to original source...
    17. Saag K, van der Heijde D, Fisher C, et al. Rofecoxib, a new cyclooxygenase 2 inhibitor, shows sustained efficacy, comparable with other nonsteroidal anti-inflammatory drugs: a 6 week and 1-year trial in patients with osteoarthritis. Arch Fam Med 2000; 9: 1124-1134. Go to original source... Go to PubMed...
    18. Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs non steroidal anti-inflammatory drugs for osteoarthritis and rhematoid arthritis. The CLASS study- a randomized controlled trial. JAMA 2000; 284: 1247-1299. Go to original source... Go to PubMed...
    19. Silverstein FE, Graham DY, Senior JR, et al. Misoprostol reduces serious gastrointestinal complications in patients with arthritis receiving non-steroidal antiinflammatory drugs - a randomized double blind placebo controlled study Ann Int Med 1995; 123: 241-249. Go to original source... Go to PubMed...
    20. Schnitzer TJ, Truitt K, Fleischmann R. The safety profile, tolerability, and effective dose range of rofecoxib in the treatment of rheumatoid arthritis. Phase II Rofecoxib Rheumatoid Arthritis Study Group. Clin Ther 1999; 21: 1688-1702. Go to original source... Go to PubMed...
    21. Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med 1999; 340: 1888-1899. Go to original source... Go to PubMed...

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