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探索布洛芬的心血管安全性概况:来自欧洲药物警戒数据库的见解。

Exploring the Cardiovascular Safety Profile of Ibuprofen: Insights from EudraVigilance Database.

作者信息

Buciuman Cristina Anamaria, Dobrea Carmen Maximiliana, Butuca Anca, Frum Adina, Gligor Felicia Gabriela, Gligor Octavia, Vicaș Laura Grațiela, Morgovan Claudiu

机构信息

Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 6 Traian Vuia Str., 020956 Bucharest, Romania.

Preclinical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania.

出版信息

Pharmaceuticals (Basel). 2025 Jul 17;18(7):1045. doi: 10.3390/ph18071045.

Abstract

: Ibuprofen is one of the most accessible non-steroidal anti-inflammatory drugs (NSADs), exhibiting non-selective reversible inhibition on COX-1 and COX-2. A series of common adverse reactions have been mentioned through the years: gastrointestinal (gastritis, ulceration, hemorrhage, or perforation), renal, hematologic, and cardiovascular. : The aim of this study was to assess the real-world impact of ibuprofen regarding cardiovascular safety, utilizing an established pharmacovigilance database. : Descriptive and disproportionality-based methods were used. Forty specific descriptors of cardiovascular effects were selected. Eight other NSADs and the combination of ibuprofen and pseudoephedrine were used as comparators. : A total of 58,760 cases were identified as being associated with ibuprofen in EudraVigilance. Stroke was reported for ibuprofen with a lower probability compared with etoricoxib (ROR: 0.34; 95% CI: 0.21-0.55), celecoxib (ROR: 0.07; 95% CI: 0.06-0.10), meloxicam (ROR: 0.25; 95% CI: 0.14-0.43), acetylsalicylic acid (ROR: 0.07; 95% CI: 0.05-0.09), and ibuprofen/pseudoephedrine (ROR: 0.11; 95% CI: 0.05-0.25). Thrombosis was reported for ibuprofen with a higher probability only relative to ketoprofen (ROR: 2.95; 95% CI: 1.71-5.09). Hypertension was reported for ibuprofen as being more probable than for acetylsalicylic acid (ROR: 1.58; 95% CI: 1.43-1.76). Myocardial infarction was reported as being more probable for ibuprofen than ketoprofen (ROR: 2.31; 95% CI: 1.57-3.40) or nimesulide (ROR: 2.43; 95% CI: 1.25-4.73). : Overall, according to our study, the probability of reported cardiovascular adverse reactions is lower than those determined for the rest of the NSAIDs; however, taking into consideration the inherent limitations of the study, further clinical investigations would contribute to a better understanding of the cardiovascular safety of ibuprofen.

摘要

布洛芬是最容易获得的非甾体抗炎药(NSADs)之一,对COX - 1和COX - 2具有非选择性可逆抑制作用。多年来已经提到了一系列常见的不良反应:胃肠道(胃炎、溃疡、出血或穿孔)、肾脏、血液学和心血管方面的不良反应。

本研究的目的是利用一个已建立的药物警戒数据库评估布洛芬对心血管安全性的实际影响。

使用了描述性和基于不成比例性的方法。选择了40个心血管效应的特定描述符。将其他8种NSADs以及布洛芬和伪麻黄碱的组合用作对照。

在欧洲药品不良反应数据库(EudraVigilance)中,共识别出58760例与布洛芬相关的病例。与依托考昔(风险比:0.34;95%置信区间:0.21 - 0.55)、塞来昔布(风险比:0.07;95%置信区间:0.06 - 0.10)、美洛昔康(风险比:0.25;95%置信区间:0.14 - 0.43)、乙酰水杨酸(风险比:0.07;95%置信区间:0.05 - 0.09)以及布洛芬/伪麻黄碱(风险比:0.11;95%置信区间:0.05 - 0.25)相比,布洛芬导致中风的报告概率较低。仅相对于酮洛芬(风险比:2.95;95%置信区间:1.71 - 5.09),布洛芬导致血栓形成的报告概率较高。与乙酰水杨酸相比,布洛芬导致高血压的报告概率更高(风险比:1.58;95%置信区间:1.43 - 1.76)。与酮洛芬(风险比:2.31;95%置信区间:1.57 - 3.40)或尼美舒利(风险比:2.43;95%置信区间:1.25 - 4.73)相比,布洛芬导致心肌梗死的报告概率更高。

总体而言,根据我们的研究,报告的心血管不良反应的概率低于其他NSADs所确定的概率;然而,考虑到本研究的固有局限性,进一步的临床研究将有助于更好地理解布洛芬的心血管安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47ec/12300713/1c76f65323ed/pharmaceuticals-18-01045-g001.jpg

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