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法国依托度酸(洛丁新)的大规模开放试验:安全性评估

Large-scale open trials with etodolac (Lodine) in France: an assessment of safety.

作者信息

Benhamou C L

机构信息

Department of Rheumatology, Regional Hospital Center, Orleans, France.

出版信息

Rheumatol Int. 1990;10 Suppl:29-34. doi: 10.1007/BF02274753.

Abstract

Two large-scale open-label studies were performed in France to confirm the efficacy and safety of etodolac (Lodine), a new non-steroidal anti-inflammatory drug (NSAID). Study I, a 6-week study performed by 974 rheumatologists, involved 4947 patients who had rheumatoid arthritis (RA), ankylosing spondylitis (AS), or osteoarthritis (OA). Both efficacy and safety were assessed. Study II, a postmarketing safety study performed by approximately 9000 general practitioners, involved 51,355 patients who had rheumatic conditions requiring therapy with NSAIDs. The daily dose of etodolac ranged from 200 to 600 mg/day in these studies, depending on the protocol and patient response. By the end of study I (visit 3), spontaneous pain improved by 33% for patients with RA, by 42% for patients with AS, and by 50% for OA patients. A total of 1276 adverse reactions (AR) were reported during the study, and fewer than half of these were related to study treatment. Only 6 severe reactions were reported; three of these were considered unrelated to study treatment, including 2 deaths. In study II, 10.1% of patients reported 6236 ARs and 9.0% of patients dropped out because of AR. Twenty-one of the ARs reported in study II were judged severe, and all of these patients recovered completely. The overall opinion of safety was assessed as very good or good by 89% of patients. In both studies (greater than 55,000 patients), 11% of patients reported an AR, and severe reactions were rare. These results confirmed the very acceptable risk/benefit ratio of etodolac and rank this drug high for efficacy and safety among the NSAIDs recently introduced in France.

摘要

在法国进行了两项大规模开放标签研究,以证实新型非甾体抗炎药依托度酸(洛索洛芬)的疗效和安全性。研究I为期6周,由974名风湿病学家开展,涉及4947例类风湿性关节炎(RA)、强直性脊柱炎(AS)或骨关节炎(OA)患者。对疗效和安全性均进行了评估。研究II是一项上市后安全性研究,由约9000名全科医生开展,涉及51355例患有需要用非甾体抗炎药治疗的风湿性疾病的患者。在这些研究中,依托度酸的日剂量根据方案和患者反应在200至600毫克/天之间。到研究I结束时(第3次访视),RA患者的自发疼痛改善了33%,AS患者改善了42%,OA患者改善了50%。研究期间共报告了1276例不良反应(AR),其中不到一半与研究治疗有关。仅报告了6例严重反应;其中3例被认为与研究治疗无关,包括2例死亡。在研究II中,10.1%的患者报告了6236例AR,9.0%的患者因AR退出研究。研究II中报告的AR有21例被判定为严重,所有这些患者均完全康复。89%的患者对安全性的总体评价为非常好或良好。在两项研究(超过55000例患者)中,11%的患者报告了AR,严重反应很少见。这些结果证实了依托度酸的风险/效益比非常可接受,并且在法国最近引入的非甾体抗炎药中,该药在疗效和安全性方面排名很高。

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