Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, University Utrecht, Heidelberglaan 100, CX, Utrecht, 3584, the Netherlands.
Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
Blood Rev. 2022 Nov;56:100987. doi: 10.1016/j.blre.2022.100987. Epub 2022 Jun 24.
(Non-)selective non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for musculoskeletal related pain. These cheap and easily accessible drugs may be of great value for hemophilia patients in developing countries and countries with a high rate of opioid poisoning, but also in developed countries due to potential joint protective effects. However, fear for adverse bleeding and cardiovascular events during the use of these drugs restrains prescription within this population. To give a complete overview of all publications reporting on safety, a systematic search till March 2021 was performed. All studies were reviewed and critically appraised and this resulted in 19 studies eligible for inclusion. Most studies with (non-)selective NSAIDs showed no evident risk for relevant adverse bleeding or cardiovascular events. However, some studies had a high risk of bias and studies reporting on cardiovascular events were limited. Future studies with longitudinal follow-up in well-defined large patient populations, including older patients, focusing on both adverse bleeding and cardiovascular events are required to confirm the alleged safe use.
（非）选择性非甾体抗炎药（NSAIDs）常用于治疗肌肉骨骼相关疼痛。这些廉价且易于获得的药物对于发展中国家和阿片类药物中毒发生率高的国家的血友病患者可能具有重要价值，但由于潜在的关节保护作用，在发达国家也同样如此。然而，由于担心使用这些药物会出现不良出血和心血管事件，因此限制了该人群的处方。为了全面了解所有报告安全性的出版物，我们进行了截至 2021 年 3 月的系统检索。对所有研究进行了审查和严格评价，最终有 19 项研究符合纳入标准。大多数（非）选择性 NSAIDs 的研究并未显示出明显的相关不良出血或心血管事件风险。然而，一些研究存在较高的偏倚风险，且报告心血管事件的研究有限。未来需要进行具有纵向随访的、针对明确大型患者人群（包括老年患者）的研究，重点关注不良出血和心血管事件，以证实其所谓的安全性。
