罗非昔布撤市对苏格兰环氧化酶-2抑制剂处方模式的影响。
The effect of the withdrawal of rofecoxib on prescribing patterns of COX-2 inhibitors in Scotland.
作者信息
Williams D, Singh M, Hind C
机构信息
Department of Clinical Pharmacology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK.
出版信息
Br J Clin Pharmacol. 2006 Sep;62(3):366-8. doi: 10.1111/j.1365-2125.2006.02691.x.
BACKGROUND
Concerns have been raised regarding the cardiovascular safety of the COX-2 inhibitors. In September 2004, rofecoxib was withdrawn from the market as a result of concerns regarding its cardiovascular safety.
AIMS & METHODS: We set out to examine the effect of the withdrawal of rofecoxib on the prescription of other COX-2 inhibitors and nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs) in Scotland, using a national prescription database.
RESULTS
The withdrawal of rofecoxib led to an initial increase in the prescription of celecoxib as prescribers presumably switched to this alternative agent. However, this rise was short-lived, presumably as a result of concerns that the safety concerning rofecoxib may be a class effect. A parallel increase in the prescription of diclofenac and ibuprofen was also noted, suggesting that prescribers were prescribing these medications as alternatives to COX-2 inhibitors.
CONCLUSIONS
While prescribers and their patients may have initially interpreted safety concerns regarding rofecoxib to be drug specific, prescribers appear to have interpreted this effect to be class specific.
背景
关于环氧化酶-2（COX-2）抑制剂的心血管安全性已引发关注。2004年9月，由于对其心血管安全性的担忧，罗非昔布被撤出市场。
目的与方法
我们利用一个全国性处方数据库，着手研究罗非昔布撤市对苏格兰其他COX-2抑制剂及非选择性非甾体抗炎药（nsNSAIDs）处方的影响。
结果
罗非昔布撤市后，塞来昔布的处方量起初有所增加，推测是开处方者转而选用了这种替代药物。然而，这种增长是短暂的，推测是由于担心罗非昔布的安全性可能是类效应。双氯芬酸和布洛芬的处方量也出现了类似增长，这表明开处方者将这些药物作为COX-2抑制剂的替代品进行处方。
结论
虽然开处方者及其患者起初可能将对罗非昔布安全性的担忧理解为药物特异性的，但开处方者似乎将这种效应理解为类特异性的。
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