Meng Qingjun, Zhang Zhen, Li Faxin, Li Jinguang, Wang Na, Guo Zhiwei, Wang Jinqiang, Ye Xiaoran, Li Yi
Department of Orthopedics, Third Hospital of Jinan, Jinan, China.
Department of Rheumatism and Immunology, Jinan Central Hospital, Jinan, China.
Ann Palliat Med. 2021 Feb;10(2):2224-2237. doi: 10.21037/apm-20-2356. Epub 2021 Jan 30.
This study aimed to evaluate the prescription patterns and safety profiles of oral nonsteroidal anti-inflammatory drugs (NSAIDs) in three Chinese hospitals.
The study analyzed the data of 50,732 patients who were prescribed oral NSAIDs from July 1, 2012 to August 31, 2019. The characteristics of these patients, the prescription patterns of NSAIDs, and the drug-related safety profiles were evaluated.
Oral NSAIDs were prescribed to patients of all ages. Of the patients, 81.88% were prescribed NSAIDs on only one occasion, and 91.64% were prescribed one type of NSAID only. The combination of different NSAIDs accounted for 2,360 person-times. Orthopedic departments most commonly used selective cyclo-oxygenase-2 (COX-2) inhibitors, while emergency departments most commonly used traditional NSAIDs. The incidences of gastrointestinal (GI) complications, cardiovascular (CV) events, and newonset hypertension were lower in patients treated with selective COX-2 inhibitors than those treated with traditional NSAIDs and NSAID combinations (P<0.05). In relation to selective COX-2 inhibitors, incidences of new-onset hypertension were lower in patients treated with imrecoxib than those treated with other types of selective COX-2 inhibitors (P=0.0102).
In respect of the at-risk patients (i.e., those with related disease, such as GI complications, CV events or other risks), the patterns with which oral NSAIDs were prescribed was not standardized. In terms of adverse effects, selective COX-2 inhibitors represent a better choice than traditional NSAIDs and NSAID combinations.
本研究旨在评估中国三家医院口服非甾体抗炎药(NSAIDs)的处方模式和安全性。
该研究分析了2012年7月1日至2019年8月31日期间50732例开具口服NSAIDs处方的患者数据。评估了这些患者的特征、NSAIDs的处方模式以及药物相关安全性。
所有年龄段的患者均有开具口服NSAIDs处方。其中,81.88%的患者仅接受过一次NSAIDs处方,91.64%的患者仅使用过一种NSAID。不同NSAIDs联合使用的人次为2360次。骨科最常使用选择性环氧化酶-2(COX-2)抑制剂,而急诊科最常使用传统NSAIDs。与使用传统NSAIDs和NSAIDs联合用药的患者相比,使用选择性COX-2抑制剂治疗的患者胃肠道(GI)并发症、心血管(CV)事件和新发高血压的发生率较低(P<0.05)。在选择性COX-2抑制剂方面,与使用其他类型选择性COX-2抑制剂治疗的患者相比,使用艾瑞昔布治疗的患者新发高血压的发生率较低(P=0.0102)。
对于高危患者(即患有相关疾病,如GI并发症、CV事件或其他风险的患者),口服NSAIDs的处方模式并不规范。在不良反应方面,选择性COX-2抑制剂比传统NSAIDs和NSAIDs联合用药是更好的选择。