对乙酰氨基酚或对乙酰氨基酚 - 可待因组合的常规使用以及非甾体抗炎药的急救治疗处方：一项基于人群的初级保健研究。

Regular use of acetaminophen or acetaminophen-codeine combinations and prescription of rescue therapy with non-steroidal anti-inflammatory drugs: a population-based study in primary care.

作者信息

Vannacci Alfredo, Lombardi Niccolò, Simonetti Monica, Fornasari Diego, Fanelli Andrea, Cricelli Iacopo, Cricelli Claudio, Lora Aprile Pierangelo, Lapi Francesco

机构信息

a Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology , University of Florence , Florence , Italy.

b Health Search , Italian College of General Practitioners and Primary Care , Florence , Italy.

出版信息

Curr Med Res Opin. 2017 Jun;33(6):1141-1148. doi: 10.1080/03007995.2017.1308920. Epub 2017 Apr 21.

DOI:10.1080/03007995.2017.1308920

PMID:28318320

Abstract

OBJECTIVE

There are contrasting positions concerning the benefit-risk ratio of acetaminophen use for osteoarthritis (OA)-related pain. To clarify the effectiveness of acetaminophen or acetaminophen-codeine combinations according to their regimen of use, we evaluated whether being a regular user (adherent) of these medications decreased the occurrence of rescue therapy with non-steroidal anti-inflammatory drugs (NSAIDs).

METHODS

Using the Health Search IMS Health Longitudinal Patient Database, we formed a cohort of patients aged ≥18 years and newly treated with acetaminophen or acetaminophen-codeine combinations for OA between 1 January 2001 and 31 December 2013. These patients were followed up for one year in which they were categorized as regular or irregular users of these medications according to a variable medication possession ratio (VMPR) ≥ 50% or lower. We operationally defined the rescue therapy as the use of any NSAIDs prescribed for OA-related pain.

RESULTS

Overall, 40,029 patients (69.5% females; mean age: 68 ± 13.57) treated with acetaminophen or acetaminophen-codeine combinations formed the cohort. After the first year of treatment, regular users showed a statistically significantly lower risk of being prescribed with rescue therapy with NSAIDs (OR = 0.89; 95% CI 0.84-0.96).

CONCLUSION

These findings show that regular use of acetaminophen or acetaminophen-codeine combinations may reduce the need for NSAIDs to treat OA-related pain.

摘要

目的

对于对乙酰氨基酚用于骨关节炎（OA）相关疼痛的效益风险比存在不同观点。为了根据使用方案阐明对乙酰氨基酚或对乙酰氨基酚 - 可待因组合的有效性，我们评估了作为这些药物的常规使用者（依从者）是否会减少非甾体抗炎药（NSAIDs）救援治疗的发生。

方法

利用健康搜索艾美仕健康纵向患者数据库，我们选取了年龄≥18岁且在2001年1月1日至2013年12月31日期间开始接受对乙酰氨基酚或对乙酰氨基酚 - 可待因组合治疗OA的患者组成队列。对这些患者进行了一年的随访，在此期间根据可变药物持有率（VMPR）≥50%或更低将他们分类为这些药物的常规或非常规使用者。我们将救援治疗操作性地定义为使用任何为OA相关疼痛开具的NSAIDs。