Traversa Giuseppe, Bianchi Clara, Da Cas Roberto, Abraha Iosief, Menniti-Ippolito Francesca, Venegoni Mauro
Department of Epidemiology, National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy.
BMJ. 2003 Jul 5;327(7405):18-22. doi: 10.1136/bmj.327.7405.18.
To estimate the risk of acute hepatotoxicity associated with nimesulide compared with other non-steroidal anti-inflammatory drugs.
Retrospective cohort and nested case-control study.
Umbria region, Italy.
400 000 current, recent, and past users (almost 2 million prescriptions) of non-steroidal anti-inflammatory drugs between 1 January 1997 and 31 December 2001.
Admissions to hospital for acute non-viral hepatitis and incidence of all hepatopathies and liver injury among users of nimesulide and other non-steroidal anti-inflammatory drugs.
Current use of non-steroidal anti-inflammatory drugs was associated with a 1.4 (95% confidence interval 1.0 to 2.1) increased risk of hepatopathy compared with past use. In current users of nimesulide the rate ratio for all hepatopathies and more severe liver injury was 1.3 (0.7 to 2.3) and 1.9 (1.1 to 3.8), respectively.
The risk of liver injury in patients taking nimesulide and other non-steroidal anti-inflammatory drugs is small.
评估与其他非甾体抗炎药相比,尼美舒利所致急性肝毒性的风险。
回顾性队列研究和巢式病例对照研究。
意大利翁布里亚地区。
1997年1月1日至2001年12月31日期间使用非甾体抗炎药的40万当前、近期及既往使用者(近200万张处方)。
因急性非病毒性肝炎入院情况以及尼美舒利和其他非甾体抗炎药使用者中所有肝病及肝损伤的发生率。
与既往使用非甾体抗炎药相比,当前使用非甾体抗炎药与肝病风险增加1.4倍(95%置信区间1.0至2.1)相关。在当前使用尼美舒利的患者中,所有肝病和更严重肝损伤的发生率比值分别为1.3(0.7至2.3)和1.9(1.1至3.8)。
服用尼美舒利和其他非甾体抗炎药的患者发生肝损伤的风险较小。