Département de Pharmacologie, Université de Bordeaux, Bordeaux, France.
Clin Pharmacol Ther. 2011 Jun;89(6):855-66. doi: 10.1038/clpt.2011.45. Epub 2011 Apr 6.
As part of the Safety of Non-Steroidal Anti-Inflammatory Drugs (SOS) Project, we reviewed the incidence of cardiovascular (CV) and gastrointestinal (GI) events associated with the use of this category of drugs. We collected data from published meta-analyses (MAs) of clinical trials of nonsteroidal anti-inflammatory drugs (NSAIDs). The Medline, Cochrane, ISI, and SCOPUS databases were systematically searched for MAs of NSAID clinical trials that could potentially contain data on adverse incidents such as myocardial infarction (MI), cerebrovascular events (CeVs), stroke, thromboembolic events (ThEs), heart failure (HF), gastrointestinal bleeding (GIB), and perforation, ulcer, and bleeding (PUB). From 1,733 identified references, 29 MAs were selected for the review. This allowed 109 estimations of incidence rates of CV adverse events and 26 estimations of incidence rates for GI adverse events. No data were found on hemorrhagic stroke or LGIB. Coxibs were studied in more MAs than traditional NSAIDs were (21 MAs for coxibs vs. 7 for traditional NSAIDs; one meta-analysis studied both). Many NSAIDs were not considered in any of the MAs. Our systematic review of MAs included information on the incidence of CV and GI events and identified important knowledge gaps regarding, in particular, the CV safety of traditional NSAIDs.
作为非甾体抗炎药安全性 (SOS) 项目的一部分，我们回顾了使用这类药物与心血管 (CV) 和胃肠道 (GI) 事件相关的发生率。我们从已发表的非甾体抗炎药 (NSAID) 临床试验荟萃分析 (MA) 中收集数据。系统地检索了 Medline、Cochrane、ISI 和 SCOPUS 数据库，以寻找可能包含心肌梗死 (MI)、脑血管事件 (CeV)、中风、血栓栓塞事件 (ThE)、心力衰竭 (HF)、胃肠道出血 (GIB) 和穿孔、溃疡和出血 (PUB) 等不良事件数据的 NSAID 临床试验 MA。从 1733 篇鉴定的参考文献中，选择了 29 篇 MA 进行综述。这允许对 109 项 CV 不良事件发生率的估计和 26 项 GI 不良事件发生率的估计。没有关于出血性中风或 LGIB 的数据。与传统 NSAIDs 相比，coxib 被更多的 MA 研究（21 项 coxibs 与 7 项传统 NSAIDs 的 MA；一项 meta 分析同时研究了两者）。许多 NSAID 在任何 MA 中都没有被考虑。我们对 MA 的系统评价包括了 CV 和 GI 事件发生率的信息，并确定了关于传统 NSAID 的 CV 安全性的重要知识差距。
