mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2010-593mrj-278Research ArticleСтатьиArticlesМелоксикам: что мы знаемо кардиоваскулярной безопасности?MELOXICAM: WHAT DO WE KNOW ABOUT CARDIOVASCULAR SAFETY?EliseevM SEliseevM S-БарсковаВ. Г.BarskovaV G-EliseyevM SEliseyevM S-БарсковаВ. Г.BarskovaV G-20101403201041№1 (2010)7983Copyright © Eliseev M.S., Барскова В.Г., Eliseyev M.S., Барскова В.Г., 20102010Eliseev M.S., Барскова В.Г., Eliseyev M.S., Барскова В.Г.Eliseev M.S., Barskova V.G., Eliseyev M.S., Barskova V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/278

Изложены современные данные о риске осложнений кардиоваскулярных заболеваний у больных с ревматическими заболеваниями при приеме мелоксикама - одного из наиболее широко используемых нестероидных противовоспалительных препаратов.

The paper presents the currently available data on a cardiovascular risk in patients with rheumatic disease when taking meloxicam, one of the widely used nonsteroidal anti-inflammatory drugs.

мелоксикамсердечно-сосудистые заболеваниянестероидные противовоспалительные препаратыmeloxicamcardiovascular diseasesnonsteroidal anti-inflammatory drugsReferences<div><p>Tramer M.R., Moore R.A., Reynolds D.J. et al. Quantitative estimation of rare adverse events which follow a biological progression: A new model applied to chronic NSAID use. Pain 2000;85(1-2):169-82.</p><p>Hawkey C., Kahan A., Steinbruck K. et al. Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br J Rheumatol 1998;37:937-45.</p><p>Dequeker J., Hawkey C., Kahan A. et al. Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Largescale Evaluation of COX-inhibiting Therapies (SELECT) trial in osteoarthritis. Br J Rheumatol 1998;37:946-51.</p><p>Dougados M., Gueguen A., Nakache J.-P. et al. Ankylosing spondylitis: what is the optimum duration of a clinical study- A one year versus a 6 weeks non-steroidal anti-inflammatory drug trial. Rheumatology 1999;38:235-44.</p><p>Degner F., Sigmund R., Zeidler H. Efficacy and tolerability of meloxicam in an observational, controlled cohort study in patients with rheumatic disease. Clin Ther 2000;22:400-10.</p><p>Chen Y.-F., Jobanputra P., Barton P. et al. Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteoarthritis and rheumatoid arthritis: a systematic review and economic evaluation. Health Technology Assessment 2008;1211:1-298.</p><p>Catella-Lawson F., Crofford L.J. Cyclooxygenase inhibition and thrombogenicity. Am J Med 2001;110(Suppl. 3A):28-2S.</p><p>Hawkey C.J. COX-2 inhibitors. Lancet 1999;353:307-14.</p><p>Bombardier C., Lane L., Reicin A. et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. New Engl J Med 2000;343:1520-8.</p><p>Bresalier R.S., Sandler R.S., Quan H. et al. for the Adenomatous Polyp Prevention on Vioxx (APPROVe) Trial Investigators. Cardiovascular events associated with rofecoxib in colorectal adenomatous chemoprevention trail. N Engl J Med 2005;352:1092-102.</p><p>Flower R. The roles of COX-1 and COX2: implications for NSAID development. Curr Opin Rheum 1996;9(Suppl. 1):S9-13.</p><p>Vane G.R., Bakchle Y.S. Bolting R.M. Cyclooxygenase 1 and 2. Ann Rev Pharmacol Toxicol 1998;38:97-120.</p><p>McAdam B.F., Catella Lawson F., Mardini I.A. et al. Systemic biosynthesis of prostacyclin by cyclooxygenase (COX) 2: the human pharmacology of a selective inhibitors of COX 2. Proc Natl Acad Sci USA 1999;96:272-7.</p><p>Tavares I.A. The effects of meloxicam, indomethacin or NS-398 on eicosanoid synthesis by fresh human gastric mucosa. Aliment Pharmacol Ther 2000;14:795-9.</p><p>Knijff-Dutmer E.A., Kalsbeek-Batenburg E.M., Koerts J. et al. Platelet function is inhibited by non-selective non-steroidal antiinflammatory drugs but not by cyclo-oxygenase2-selective inhibitors in patients with rheumatoid arthritis. Rheumatology (Oxford) 2002;41(4):458-61. 16.</p><p>De Meijer A., Vollaard H., De Metz M. et al. Meloxicam, 15 mg/day, spares platelet function in healthy volunteers. Clin Pharmacol Ther 1999;66:425-30.</p><p>Freestone S., Bello A. Comparison of the effect of celecoxib, meloxicam, and nimesulide on platelet function in healthy subjects. Ann Rheum Dis 2005;64(Suppl. 3):1603.</p><p>Layton D., Hughes K., Harris S. et al. Comparison of the incidence rates of thromboembolic events reported for patients prescribed celecoxib and meloxicam in general practice in England using Prescription-Event Monitoring (PEM) data. Rheumatology 2003;42:1354-64.</p><p>Frishman W.H. Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. Am J Cardiol 2002;89(6A):18-25D.</p><p>Wolfe F., Zhao S., Pettitt D. Blood pressure destabilization and edema among 8538 users of celecoxib, rofecoxib, and nonselective nonsteroidal antiinflammatory drugs (NSAID) and nonusers of NSAID receiving ordinary clinical care. J Rheumatol 2004;31(6):1143-51.</p><p>Chan C.C., Reid C.M., Aw T.J. et al. Do COX-2 inhibitors raise blood pressure more than nonselective NSAIDs and placebo- An updated meta-analysis. J Hypertens 2009;27(12):2332-41.</p><p>Helin-Salmivaara A., Virtanen A., Vesalainen R. et al. NSAID use and the risk of hospitalization for first myocardial infarction in the general population: a nationwide case-control study from Finland. Eur Heart J 2006;27(14):1657-63.</p><p>Singh G., Triadafilopoulos G. Meloxicam has a low risk of serious gastrointestinal complications: pooled analysis of 27 039 patients [abstract]. Ann Rheum Dis 2001;60(Suppl. 1):235.</p><p>Singh G., Lanes S., Triadafilopoulos G. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. Am J Med 2004;117(2):100-6.</p><p>Singh G., A. Mannalithara A., Wang H. When COX-2 selectivity does not matter: risk of stroke with NSAIDs in patients with arthritis. Ann Rheum Dis 2007;66(Suppl. II):510.</p><p>Altman R., Luciardi H.L., Muntaner J. et al. Efficacy of assessment of meloxicam, a preferential COX-2 inhibitor in acute coronary syndromes without ST-segment elevation: the NUT-2 pilot study. Circulation 2002;106:191-5.</p><p>Елисеев М.С., Барскова В.Г., Владимиров С.А. Применение инъекционной формы мелоксикама (Амелотекс) у больных гонартрозом. Совр ревматол 2009;3:53-6. 28.</p><p>Van Ryn J., Kink-Eiband M., Kuritsch I. et al. Meloxicam does not affect the antiplatelet effect of aspirin in healthy male and female volunteers. J Clin Pharmacol 2004;44(7):777-84.</p><p>Mueller F.O., Middle M.V., Schall R. et al. An evaluation of the interaction of meloxicam with frusemide in patients with compensated chronic cardiac failure. Br J Clin Pharmacol 1997;44:393-8.</p><p>Tuerck D., Su C.A.P.F., Heinzel G. et al. Lack of interaction between meloxicam and warfarin in healthy volunteers. Eur J Clin Pharmacol 1997;51:421-5.</p></div><br /><div><p>Tramer M.R., Moore R.A., Reynolds D.J. et al. Quantitative estimation of rare adverse events which follow a biological progression: A new model applied to chronic NSAID use. Pain 2000;85(1-2):169-82.</p><p>Hawkey C., Kahan A., Steinbruck K. et al. Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br J Rheumatol 1998;37:937-45.</p><p>Dequeker J., Hawkey C., Kahan A. et al. Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Largescale Evaluation of COX-inhibiting Therapies (SELECT) trial in osteoarthritis. Br J Rheumatol 1998;37:946-51.</p><p>Dougados M., Gueguen A., Nakache J.-P. et al. Ankylosing spondylitis: what is the optimum duration of a clinical study- A one year versus a 6 weeks non-steroidal anti-inflammatory drug trial. Rheumatology 1999;38:235-44.</p><p>Degner F., Sigmund R., Zeidler H. Efficacy and tolerability of meloxicam in an observational, controlled cohort study in patients with rheumatic disease. Clin Ther 2000;22:400-10.</p><p>Chen Y.-F., Jobanputra P., Barton P. et al. Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteoarthritis and rheumatoid arthritis: a systematic review and economic evaluation. Health Technology Assessment 2008;1211:1-298.</p><p>Catella-Lawson F., Crofford L.J. Cyclooxygenase inhibition and thrombogenicity. Am J Med 2001;110(Suppl. 3A):28-2S.</p><p>Hawkey C.J. COX-2 inhibitors. Lancet 1999;353:307-14.</p><p>Bombardier C., Lane L., Reicin A. et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. New Engl J Med 2000;343:1520-8.</p><p>Bresalier R.S., Sandler R.S., Quan H. et al. for the Adenomatous Polyp Prevention on Vioxx (APPROVe) Trial Investigators. Cardiovascular events associated with rofecoxib in colorectal adenomatous chemoprevention trail. N Engl J Med 2005;352:1092-102.</p><p>Flower R. The roles of COX-1 and COX2: implications for NSAID development. Curr Opin Rheum 1996;9(Suppl. 1):S9-13.</p><p>Vane G.R., Bakchle Y.S. Bolting R.M. Cyclooxygenase 1 and 2. Ann Rev Pharmacol Toxicol 1998;38:97-120.</p><p>McAdam B.F., Catella Lawson F., Mardini I.A. et al. Systemic biosynthesis of prostacyclin by cyclooxygenase (COX) 2: the human pharmacology of a selective inhibitors of COX 2. Proc Natl Acad Sci USA 1999;96:272-7.</p><p>Tavares I.A. The effects of meloxicam, indomethacin or NS-398 on eicosanoid synthesis by fresh human gastric mucosa. Aliment Pharmacol Ther 2000;14:795-9.</p><p>Knijff-Dutmer E.A., Kalsbeek-Batenburg E.M., Koerts J. et al. Platelet function is inhibited by non-selective non-steroidal antiinflammatory drugs but not by cyclo-oxygenase2-selective inhibitors in patients with rheumatoid arthritis. Rheumatology (Oxford) 2002;41(4):458-61. 16.</p><p>De Meijer A., Vollaard H., De Metz M. et al. Meloxicam, 15 mg/day, spares platelet function in healthy volunteers. Clin Pharmacol Ther 1999;66:425-30.</p><p>Freestone S., Bello A. Comparison of the effect of celecoxib, meloxicam, and nimesulide on platelet function in healthy subjects. Ann Rheum Dis 2005;64(Suppl. 3):1603.</p><p>Layton D., Hughes K., Harris S. et al. Comparison of the incidence rates of thromboembolic events reported for patients prescribed celecoxib and meloxicam in general practice in England using Prescription-Event Monitoring (PEM) data. Rheumatology 2003;42:1354-64.</p><p>Frishman W.H. Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. Am J Cardiol 2002;89(6A):18-25D.</p><p>Wolfe F., Zhao S., Pettitt D. Blood pressure destabilization and edema among 8538 users of celecoxib, rofecoxib, and nonselective nonsteroidal antiinflammatory drugs (NSAID) and nonusers of NSAID receiving ordinary clinical care. J Rheumatol 2004;31(6):1143-51.</p><p>Chan C.C., Reid C.M., Aw T.J. et al. Do COX-2 inhibitors raise blood pressure more than nonselective NSAIDs and placebo- An updated meta-analysis. J Hypertens 2009;27(12):2332-41.</p><p>Helin-Salmivaara A., Virtanen A., Vesalainen R. et al. NSAID use and the risk of hospitalization for first myocardial infarction in the general population: a nationwide case-control study from Finland. Eur Heart J 2006;27(14):1657-63.</p><p>Singh G., Triadafilopoulos G. Meloxicam has a low risk of serious gastrointestinal complications: pooled analysis of 27 039 patients [abstract]. Ann Rheum Dis 2001;60(Suppl. 1):235.</p><p>Singh G., Lanes S., Triadafilopoulos G. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. Am J Med 2004;117(2):100-6.</p><p>Singh G., A. Mannalithara A., Wang H. When COX-2 selectivity does not matter: risk of stroke with NSAIDs in patients with arthritis. Ann Rheum Dis 2007;66(Suppl. II):510.</p><p>Altman R., Luciardi H.L., Muntaner J. et al. Efficacy of assessment of meloxicam, a preferential COX-2 inhibitor in acute coronary syndromes without ST-segment elevation: the NUT-2 pilot study. Circulation 2002;106:191-5.</p><p>Елисеев М.С., Барскова В.Г., Владимиров С.А. Применение инъекционной формы мелоксикама (Амелотекс) у больных гонартрозом. Совр ревматол 2009;3:53-6. 28.</p><p>Van Ryn J., Kink-Eiband M., Kuritsch I. et al. Meloxicam does not affect the antiplatelet effect of aspirin in healthy male and female volunteers. J Clin Pharmacol 2004;44(7):777-84.</p><p>Mueller F.O., Middle M.V., Schall R. et al. An evaluation of the interaction of meloxicam with frusemide in patients with compensated chronic cardiac failure. Br J Clin Pharmacol 1997;44:393-8.</p><p>Tuerck D., Su C.A.P.F., Heinzel G. et al. Lack of interaction between meloxicam and warfarin in healthy volunteers. Eur J Clin Pharmacol 1997;51:421-5.</p></div><br />

The authors declare that there are no conflicts of interest present.