Konstantinidis Ioannis, Papageorgiou Spyridon N, Kyrgidis Athanassios, Tzellos Thrasivoulos-George, Kouvelas Dimitrios
Mount Sinai School of Medicine, New York, NY, USA.
Rev Recent Clin Trials. 2013 Mar;8(1):48-60. doi: 10.2174/1574887111308010008.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for acute and chronic pain control and treatment of inflammation, osteoarthritis and rheumatoid arthritis. NSAIDs have been shown to inhibit bone healing in animal studies due to the inhibition of prostaglandin synthesis. However, little evidence exists regarding the effect of NSAID exposure on human bone metabolism. This systematic review summarizes the current literature of randomized controlled trials (RCTs) investigating NSAIDs with bone remodeling-related outcomes in humans. After performing computerized searches in the most widely indexed databases, study selection, data abstraction and risk of bias assessment were conducted in duplicate. The results were controversial regarding the association of NSAID with bone formation or resorption. Increased bone mineral density following NSAID exposure was reported by some studies. Based on the levels of biochemical markers, no effect was seen on bone formation, while some evidence was found for a decreased rate of bone resorption in NSAID patients. Trials investigating the effects of NSAID treatment on bone metabolism outcomes of human patients are limited. Further research is required to confirm or refute the findings of this systematic review.
非甾体抗炎药（NSAIDs）常用于急性和慢性疼痛控制以及炎症、骨关节炎和类风湿性关节炎的治疗。在动物研究中，NSAIDs已被证明会因抑制前列腺素合成而抑制骨愈合。然而，关于NSAIDs暴露对人体骨代谢的影响，几乎没有证据。本系统评价总结了目前关于研究NSAIDs与人类骨重塑相关结局的随机对照试验（RCTs）的文献。在最广泛索引的数据库中进行计算机检索后，研究选择、数据提取和偏倚风险评估均进行了重复操作。关于NSAIDs与骨形成或骨吸收的关联，结果存在争议。一些研究报告称NSAIDs暴露后骨矿物质密度增加。基于生化标志物水平，未发现对骨形成有影响，而在NSAIDs患者中发现了一些骨吸收速率降低的证据。研究NSAIDs治疗对人类患者骨代谢结局影响的试验有限。需要进一步研究来证实或反驳本系统评价的结果。
