Scanzello Carla R, Moskowitz Neal K, Gibofsky Allan
Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Curr Rheumatol Rep. 2008 Jan;10(1):49-56. doi: 10.1007/s11926-008-0009-6.
Traditionally, clinicians have relied heavily on the use of NSAIDs to treat the pain of osteoarthritis, as numerous studies have proven these agents effective. However, controversy has arisen regarding their use as first-line therapy, due to increasing awareness of their cardiovascular risks. One of these agents, rofecoxib, was withdrawn from the market in 2004 due to these concerns. Since that time, numerous studies have illustrated that many of the NSAIDs, both the selective cyclooxygenase-2 inhibitors and the traditional nonselective agents, may confer similar risks of cardiovascular toxicity. Although these agents may still be useful in many patients, concerns over side effects have begun to limit their use, and patients and clinicians are reaching for alternate agents. This review highlights the evidence behind the effectiveness of other, non-NSAID pharmacologic options in the treatment of pain and inflammation in osteoarthritis.
传统上，临床医生严重依赖使用非甾体抗炎药（NSAIDs）来治疗骨关节炎疼痛，因为大量研究已证明这些药物有效。然而，由于对其心血管风险的认识不断提高，关于将其用作一线治疗药物引发了争议。其中一种药物罗非昔布，就因这些担忧于2004年退出市场。自那时起，大量研究表明，许多NSAIDs，包括选择性环氧化酶-2抑制剂和传统的非选择性药物，可能都具有类似的心血管毒性风险。尽管这些药物在许多患者中可能仍然有用，但对副作用的担忧已开始限制其使用，患者和临床医生正在寻求替代药物。本综述强调了其他非NSAID药物治疗骨关节炎疼痛和炎症有效性背后的证据。
