Prónai L
Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest.
Orv Hetil. 2001 Sep 2;142(35):1899-905.
Non-steroidal anti-inflammatory drugs (NSAID) are the most widely used drugs in the world. Gastrointestinal (GI) side effects of NSAID have a significant economical impact (3-4% clinical GI event, and 1.5% serious/life threatening GI event/year). Selective cyclooxigenase-2 inhibitors (coxibs) are equally effective as non-selective NSAID with about 50% reduction of serious/life threatening GI events. Serious GI events are significantly less in high-risk patients (history of peptic ulcer disease, age over 65 years, treatment with anticoagulants), therefore the use of coxibs is cost-effective in these population. Most of patients with long-term NSAID therapy also require co-therapy with acid suppression or prostaglandin analogue, but coxibs may replace both. The treatment with coxibs in long-term NSAID users thus is cheaper then non-selective NSAID + co-therapy. Patients with GI adverse events during coxib therapy require co-therapy with acid suppression or prostaglandin analogue.
非甾体抗炎药（NSAID）是世界上使用最广泛的药物。NSAID的胃肠道（GI）副作用具有重大经济影响（每年3 - 4%的临床GI事件，以及1.5%的严重/危及生命的GI事件）。选择性环氧化酶-2抑制剂（coxibs）与非选择性NSAID同样有效，严重/危及生命的GI事件减少约50%。高危患者（消化性溃疡病史、65岁以上、接受抗凝治疗）的严重GI事件明显较少，因此在这些人群中使用coxibs具有成本效益。大多数长期接受NSAID治疗的患者也需要联合使用抑酸剂或前列腺素类似物进行治疗，但coxibs可能可以替代这两者。因此，长期使用NSAID的患者使用coxibs治疗比非选择性NSAID + 联合治疗更便宜。在coxib治疗期间出现GI不良事件的患者需要联合使用抑酸剂或前列腺素类似物进行治疗。
