Shi W, Wang Y M, Li S L, Yan M, Chen B Y, Chen N N, Li D
Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai, China.
Drugs Exp Clin Res. 2003;29(4):161-8.
The aim of this study was to investigate the risk factors for adverse drug reactions (ADRs) to nimesulide in patients from Shanghai with osteoarthropathy. A retrospective epidemiological study was performed to obtain information (observational variables) on demographics, primary disease, family history of disease, quality of life, dietary habits, lifestyle, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and ADR history of NSAIDs. Univariate and multivariate analyses were performed to establish the relationship between these observational variables and the occurrence of ADRs caused by nimesulide. Among the 726 variables, five risk factors for ADRs to nimesulide were identified. The study showed an increased risk for ADR occurrence with increased scoring of the following four factors: (i) "Concomitant drug therapy" (odds ratio [OR]: 4.66, 95% confidence intervals [CI]: 1.26-17.26, p < 0.05); (ii) "Compared with six months ago, how would you rate your health in general now?" (OR: 1.38, 95% CI: 1.03-1.84, p < 0.05); (iii) "General feeling of health status" (OR: 1.27, 95% CI: 1.03-1.56, p < 0.05) and (iv) "1 expect my health to get worse" (OR: 2.05, 95% CI: 1.22-3.44, p < 0.01). There was a decreased risk for ADR occurrence with increased scoring of the factor "Have you ever suffered from depression that impacted on your life?" (OR: 0.15, 95% CI: 0.03-0.66, p < 0.05). The predictive model for the overall incidence rate of ADRs caused by nimesulide was then established. In conclusion, the predictive model helps to indicate the risk of ADRs to nimesulide and provides clinicians with an alternative method for decision making when prescribing this drug.
本研究旨在调查上海骨关节炎患者中尼美舒利药物不良反应(ADR)的危险因素。开展了一项回顾性流行病学研究,以获取有关人口统计学、原发性疾病、家族病史、生活质量、饮食习惯、生活方式、非甾体抗炎药(NSAIDs)使用情况以及NSAIDs不良反应史等方面的信息(观察变量)。进行单因素和多因素分析,以确定这些观察变量与尼美舒利所致ADR发生之间的关系。在726个变量中,确定了尼美舒利ADR的五个危险因素。研究表明,随着以下四个因素得分增加,ADR发生风险升高:(i)“联合药物治疗”(比值比[OR]:4.66,95%置信区间[CI]:1.26 - 17.26,p < 0.05);(ii)“与六个月前相比,您现在总体健康状况如何评价?”(OR:1.38,95% CI:1.03 - 1.84,p < 0.05);(iii)“健康状况总体感觉”(OR:1.27,95% CI:1.03 - 1.56,p < 0.05)以及(iv)“我预计自己的健康会变差”(OR:2.05,95% CI:1.22 - 3.44,p < 0.01)。随着“您是否曾患过影响生活的抑郁症?”这一因素得分增加,ADR发生风险降低(OR:0.15,95% CI:0.03 - 0.66,p < 0.05)。随后建立了尼美舒利所致ADR总体发生率的预测模型。总之,该预测模型有助于指出尼美舒利ADR的风险,并为临床医生在开具此药时提供一种辅助决策方法。