塞来昔布与非选择性非甾体抗炎药治疗强直性脊柱炎患者时心血管疾病和胃肠道出血风险相当：一项全国性回顾性队列研究

Risk of cardiovascular diseases and gastrointestinal bleeding is comparable between celecoxib and non-selective non-steroidal anti-inflammatory drugs in patients with ankylosing spondylitis: a nationwide retrospective cohort study.

作者信息

Kim A, Kim S C, Kim J, So M W, Lee S-G

机构信息

Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea.

Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.

出版信息

Scand J Rheumatol. 2025 May;54(3):204-212. doi: 10.1080/03009742.2025.2467556. Epub 2025 Mar 3.

DOI:10.1080/03009742.2025.2467556

PMID:40028763

Abstract

OBJECTIVE

To compare the risk of cardiovascular disease (CVD) and gastrointestinal bleeding (GIB) between celecoxib and non-selective non-steroidal anti-inflammatory drugs (nsNSAIDs) in patients with ankylosing spondylitis (AS).

METHOD

In this nationwide retrospective cohort study using the Korean Health Insurance Review and Assessment database, adult AS patients who received newly prescribed non-steroidal anti-inflammatory drugs (NSAIDs) continuously for ≥ 30 days (celecoxib or nsNSAIDs) between 2013 and 2017 were evaluated. The co-primary outcomes were the occurrence of composite CVD events, including hospitalization for myocardial infarction, ischaemic heart disease, stroke, transient ischaemic attack, heart failure, and coronary revascularization; and composite GIB, including hospitalization for upper and lower GIB. Propensity score (PS) matching was used to correct for baseline differences between the celecoxib- and nsNSAID-treated groups.

RESULTS

We identified 3164 celecoxib-treated and 18924 nsNSAID-treated patients with AS. After 1:1 PS matching, 3047 patients with AS were assigned to each of the celecoxib- and nsNSAID-treated groups. The incidence of composite CVD and GIB was 18.2/1000 person-years and 6.5/1000 person-years in celecoxib-treated and 15.1/1000 person-years and 7.3/1000 person-years in nsNSAID-treated patients, respectively. Compared to the nsNSAID-treated group, the hazard ratios of composite CVD and GIB in the celecoxib-treated group were not significant, with values of 1.17 (p = 0.499) and 0.87 (p = 0.696), respectively. There were no significant differences in the risk of each component of the composite CVD and GIB between the two groups.

CONCLUSION

We did not find significant differences in the risks of CVD and GIB between celecoxib and nsNSAIDs in AS patients.

摘要

目的

比较塞来昔布与非选择性非甾体抗炎药（nsNSAIDs）在强直性脊柱炎（AS）患者中发生心血管疾病（CVD）和胃肠道出血（GIB）的风险。

方法

在这项利用韩国健康保险审查与评估数据库进行的全国性回顾性队列研究中，对2013年至2017年间连续新开具非甾体抗炎药（NSAIDs）（塞来昔布或nsNSAIDs）且用药≥30天的成年AS患者进行评估。共同主要结局为复合CVD事件的发生，包括因心肌梗死、缺血性心脏病、中风、短暂性脑缺血发作、心力衰竭和冠状动脉血运重建住院；以及复合GIB，包括因上、下消化道出血住院。采用倾向评分（PS）匹配来校正塞来昔布治疗组和nsNSAIDs治疗组之间的基线差异。

结果

我们确定了3164例接受塞来昔布治疗的AS患者和18924例接受nsNSAIDs治疗的AS患者。经过1:1 PS匹配后，3047例AS患者被分配到塞来昔布治疗组和nsNSAIDs治疗组。接受塞来昔布治疗的患者中复合CVD和GIB的发生率分别为18.2/1000人年和6.5/1000人年，接受nsNSAIDs治疗的患者中分别为15.1/1000人年和7.3/1000人年。与nsNSAIDs治疗组相比，塞来昔布治疗组复合CVD和GIB的风险比无显著差异，分别为1.17（p = 0.499）和0.87（p = 0.696）。两组之间复合CVD和GIB各组成部分的风险无显著差异。