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Actual view on the non-steroidal anti-inflammatory drugs in geriatrics treatment


Authors: M. Forejtová
Authors‘ workplace: Revmatologický ústav Praha
Published in: Geriatrie a Gerontologie 2013, 2, č. 1: 24-31
Category: Review Article

Overview

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs. Their administration is accompanied by a relatively frequent occurrence of adverse gastrointestinal events. Coxibs have been developed to reduce the risk of adverse events in the gastrointestinal tract, but it was later found that they could increase the incidence of cardiovascular events. Recently, however, it has been shown that the cardiotoxic effect to varying degrees all NSAIDs, for example, and diclofenac, ibuprofen, etc. The concomitant use of acetylsalicylic acid (KAS) reduces the risk of cardiovascular events when administered with celecoxib, meloxicam or indomethacin, However, its effect can be reduced by concomitant administration of ibuprofen. Benefit of coxibs in the gastrointestinal tract than traditional NSAIDs is maintained in the case of concomitant use KAS, have simultaneously compared with neselektivnímu NSA lower incidence of side effects in the lower gastrointestinal tract. Consideration should be given for each individual gastroinestinálního ratio and cardiovascular risk, assess other risk factors, and according to then choose the optimal therapeutic approach.

Key words:
NSAIDs – coxibs – cardiovascular accident – gastrointestinal toxicity


Sources

1. Langman MJ, Weil J, Wainwright P et al.: Risk of bleeding peptic ulcer associated with individual nonsteroidal antiinflammatory drugs. Lancet 1994; 343: 1075–1078.

2. Vonkemann HE, van der Laar M.: Nonsteroidal anti-inflammatory drugs: adverse effects and their prevention. Semin Arthritis Rheum 2010; 39: 294–312.

3. Pirmohamed M, James S, Meakin S et al.: Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329: 1519.

4. Talley NJ, Evans JM, Fleming KC et al.: Nonsteroidal antiinflammatory drug and dyspepsia in the elderly. Dig Dis Sci l995; 40: 1345–1350.

5. Allison MC, Howatson AG, Torrance CJ et al.: Gastrointestinal damage associated with the use of non-steroidal anti-inflammatory drugs. N Engl J Med 1992; 327: 749–754.

6. Singh H, Triadafilopoulos G.: Epidemiology of NSA-induced GI complications. J Rhemuatol 1999; 26: 18–24.

7. Shah S, Mehta V.: Controversies and advances in nonsteroidal anti-inflammatory drug (NSAID) analgesia in chronic pain managment. Postgrad Med J 2012; 88: 73–78.

8. Shorr RJ, Ray WA, Daugherty JR et al.: Concurent use of nonsteroidal anti-inflammatory drugs and oral anticoagulants places elderly persons at high risk for hemorrhagic peptic ulcer diseases. Arch Intern Med 1993; 153: 1665–1670.

9. Rostom A, Dube C, Wells GA et al.: Prevention of NSAID-induced gastroduodenal ulcers (Review). Cochrane Database Syst Rev. 2002; (4): CD002296.

10. Bombardier C, Laine L, Reicin A et al.: Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 2000; 343(21): 1520–1528.

11. Silverstein FE, Faich G, Goldstein JL et al.: Gastrointestinal toxicity with celekoxib vs. nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis; the CLASS study: a randomized controlled trial. Celekoxib long-therm artrhritis safety study. JAMA 2000; 284(10): 1247–1255.

12. Schnitzer T, Burmester GR, Mysler E et al.: Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), reduction in ulcer complications: randomised controlled trial. Lancet 2004; 364: 665–674.

13. Hawkey CJ, Gitton X, Hoexter E et al.: Gastrointestinal tolerability of lumiracoxib in patients with osteoarthritis and rheumatoid arthritis. Clin Gastroenterol Hepatol 2006; 4: 57–66.

14. Fries JF, Williams Ca, Bloch DA et al.: Nonsteroidal anti-inflammatory drugs associated gastropathy: incidence and risk factor model. Am J Med 1991: 91: 213–222.

15. Chan FKL, Cryer B, Goldstein JL et al.: A novel composite endpoint to evaluate the gastrointestinal (GI) effects of nonsteroidal antiinflammatory drugs through the entire GI tract. J Rheumatol 2010; 37: 167–174.

16. Chan FK, Lanas A, Scheiman J et al.: Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet 2010; 376(9736): 173–179.

17. Graham DJ, Campen D, Hui R et al.: Risk of acute maocardial infarction and sudden cardiac death in patiens treated with cyclooxygenase 2 selective and non-selective non-steroidal anti-inflammatory drugs: nested case-control study. Lancet 2005; 365: 475–481.

18. Lee TA, Bartle B, Weiss KB.: Impact of NSAIDS on mortality and the effect of preexisting coronary artery disease in US veterans. Am J Med 2007; 120: 98e9–16

19. Chan AT, Manson JE, Albert CHM et al.: Nonsteroidal Antiinflammatory Drugs, Acetaminophen, and the Risk of Cardiovascular Events. Circulation 2006; 113: 1578–1590.

20. Trelle S, Reichenbach S, Wandel S et al.: Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ 2011: 342 : c7086. doi: 10.1136/bmj.c7086.

21. Hudson M, Hugues R, Pilote L.: Differences in outcomes of patiens with congestive heart failure precribed celekoxib, rofecoxib, or non-steroidal anti-inflammatory drug: population based study. BMJ 2005; 330: 1365–1370.

22. Salvo F, Fourrier-Réglát A, Bazin F et al.: Cardiovascular and gastrointestinal safety of NSAIDs: a systemic review of meta-analyses of randomized clinical trials. Clinical Pharmacology &Therapeutics 2011; 89(6): 855–866.

23. Dieppe PA, Lohmander LS: Pathogenesis and management of pain in osteoarthritis. Lancet 2005; 365: 965–973.

24. Jordan KM, Arden N, Doherty M et al.: EULAR Recommendation 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Comittee for International Clinical Studies including Therapeutisc Trials (ESCISIT). Ann Rheum Dis 2003; 62: 1145–1155.

25. Zhang W, Doherty M, Arden N et al.: EULAR evidence based recommendation for the management of hip osteoarthritis: Report of a Task Force of the EULAR Standing Comittee for International Clinical Studies including Therapeutisc (ESCISIT) Ann Rheum Dis 2005; 64: 669–681.

26. Zhang W, Doherty M, Leeb BF et al.: EULAR evidence based recommendation for the management of hand osteoarthritis: Report of a Task Force of the EULAR Standing Comittee for International Clinical Studies including Therapeutisc (ESCISIT) Ann Rheum Dis 2007; 66: 377–388.

27. Rashad S, Revell P, Hemingway et al.: Effect of non-steroidal anti-inflammatory drugs on the course of osteoarthritis. Lancet 1989; 2: 519–522.

28. Huskisson EC, Berry H, Gishen P et al.: Effects of antiinflammatory drugs on the progression of osteoarthritis of the knee. LINK Study Group. Longitudinal Investigation of Nonsteroidal Antiinflammatory Drugs in Knee Osteoarthritis. J Rheumatol 1995; 22: 1941–1946.

29. Pavelka K. A comparison of the therapeutic efficacy of diclofenac in osteoarthritis: a systemic review of randomised controlled trials. Current Medical Research &Opinion 2012; 28(1): 163–175.

30. Poddubnyy D, Rudwaleit M, Haibel H et al.: Effect of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondylarthritis: results from the German Spondylarthritis Inception Cohort. Ann Rheum Dis 2012; 71: 1616–1622.

31. Strand V. Are COX-2 inhibitors preferable to non-selective non-steroidal anti-inflammatory drugs in patients with risk of cardiovascular events taking low-dose aspirin? Lancet 2008; 370: 2138–51.

32. Kuehl K, Carr W, Yanchick J et al.: Analgesic efficacy and safety of the diclofenac epolamine topical patch 1.3 % (DETP) in minor soft tissue injury. Int J Sports Med. 2011; 32(8): 635–643.

33. Derry S, Moore RA, Rabbie R: Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 2012 Sep 12;9:CD007400. doi: 10.1002/14651858.CD007400.pub2.

34. Trnavský K, Fischer V, Vogtle-Jinkert et al.: Efficacy and safety of 5 % ibuprofen Cream treatment in knee OA. Results of randomised, double-blind , placebo- controlled study. J Rheumatol 2004; 32: 565–72.

35. EMEA Press Release: European Medicine Agency confirms positive benefit-risk Balance of topical formulations of ketoprofen. London, UK, EMEA, 2010 Doc REl EMA/CHMP/455633/2010.

36. Peters MJL, Symmons DPM, McCarey D et al.: EULAR evidence-based recommendation for cardiovascular risk managment in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 2010; 69: 325–331.

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Geriatrics General practitioner for adults Orthopaedic prosthetics
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