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Современная ревматология

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Количественная и качественная оценка риска осложнений при использовании нестероидных противовоспалительных препаратов как основа формирования рекомендаций по их контролю и профилактике

https://doi.org/10.14412/1996-7012-2014-1-64-72

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Аннотация

Нестероидные противовоспалительные препараты (НПВП) были и остаются основным средством купирования острой и контроля хронической боли в терапевтической практике. Однако эти препараты могут вызывать серьезные осложнения, что существенно сдерживает их применение. Практические врачи нуждаются в четких и обоснованных рекомендациях по назначению НПВП в зависимости от наличия коморбидной патологии и факторов риска со стороны желудочно-кишечного тракта и сердечно-сосудистой системы. Ведущие мировые эксперты до настоящего времени активно занимаются данной проблемой. В статье рассмотрены основные аспекты эффективности и безопасности НПВП, проведена градация факторов риска по их значимости и предложен алгоритм рационального назначения этих препаратов, включая меры профилактики возможных осложнений.

Об авторе

Андрей Евгеньевич Каратеев
ФГБУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой РАМН», Москва, Россия; 115522, Москва, Каширское шоссе, 34A
Россия


Литература

1. <div><p>Яхно НН, Кукушкина МЛ, редакторы. Боль (практическое руководство для врачей). Москва: Издательство РАМН; 2012. 512 c. [Yakhno NN, Kukushkina ML, redaktory. Bol' (prakticheskoe rukovodstvo dlya vrachei). Moscow: Izdatel'stvo RAMN; 2012. 512 p.]</p><p>Blondell RD, Azadfard M, Wisniewski AM. Pharmacologic therapy for acute pain. Am Fam Physician. 2013 Jun 1;87(11):766–72.</p><p>Crofford LJ. Use of NSAIDs in treating patients with arthritis. Arthritis Res Ther. 2013;15 Suppl 3:S2. DOI: 10.1186/ar4174. Epub 2013 Jul 24.</p><p>Насонов ЕЛ. Анальгетическая терапия в ревматологии: путешествие между Сциллой и Харибдой. Клиническая фармакология и терапия. 2003;12(1):64–9. [Nasonov EL. Anal'geticheskaya terapiya v revmatologii: puteshestvie mezhdu Stsilloi i Kharibdoi. Klinicheskaya farmakologiya i terapiya. 2003;12(1):64–9.]</p><p>Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug 31;382(9894):769–79. DOI: 10.1016/S0140-6736(13)60900-9. Epub 2013 May 30.</p><p>Dubois R, Melmed G, Henning J, Lane L. Guidelines for the appropriate use of non-steroidal anti-inflammatory drugs, cyclooxy-genase-2 specific inhibitors and proton pump inhibitors in patients requiring chronic anti-inflammatory therapy. Aliment Pharmacol Ther. 2004;19(2):197–208. DOI: http://dx.doi.org/10.1111/j.0269-2813.2004.01834.x.</p><p>Burmester G, Lanas A, Biasucci L, et al. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. Ann Rheum Dis. 2011;70(5):818–22. DOI: http://dx.doi.org/10.1136/ard.2010.128660.</p><p>Каратеев АЕ, Яхно НН, Лазебник ЛБ и др. Применение нестероидных противовоспалительных препаратов. Клинические рекомендации. Москва: ИМА-ПРЕСС; 2009. 167 с. [Karateev AE, Yakhno NN, Lazebnik LB i dr. Primenenie nesteroidnykh protivovospalitel'nykh preparatov. Klinicheskie rekomendatsii. Moscow: IMA-PRESS; 2009. 167 p.]</p><p>Hосhberg M, Altman R, April K, et al. American College of Rheumatology 2012 Recom-mendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip and Knee. Arthritis Care Res. 2012;64(4):465–74. DOI: http://dx.doi.org/10.1002/acr.21596.</p><p>Zhang W, Nuki G, Moskowitz R, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of re-search published through January 2009. Osteoarthritis Cartilage. 2010;18(4):476–99. DOI: 10.1016/j.joca.2010.01.013. Epub 2010 Feb 11.</p><p>Насонов ЕЛ, редактор. Ревматология. Клинические рекомендации. Москва: ГЭОТАР-Медиа; 2010. 752 с. [Nasonov EL, redaktor. Revmatologiya. Klinicheskie rekomendatsii. Moscow: GEO-TAR-Media; 2010. 752 p.]</p><p>Towheed T, Maxwell L, Judd M, et al. Acetaminophen for osteoarthritis. Cochrane Database Syst Rev. 2006;25(1):CD004257.</p><p>Davies R, Maher C, Hancock M. A systematic review of paracetamol for non-specific low back pain. Eur Spine J. 2008;17(11):1423–30. DOI: 10.1007/s00586-008-0783-x.</p><p>Pincus T, Koch G, Lei H, et al. Patient Preference for Placebo, Acetaminophen (paracetamol) or Celecoxib Efficacy Studies (PACES): two randomised, double blind, placebo controlled, crossover clinical trials in patients with knee or hip osteoarthritis. Ann Rheum Dis. 2004;63(8):931–9. DOI: http://dx.doi.org/10.1136/ard.2003.020313. Epub 2004 Apr 13.</p><p>O'Donnell J, Ekman E, Spalding W, et al. The effectiveness of a weak opioid medication versus a cyclo-oxygenase-2 (COX-2) selective non-steroidal anti-inflammatory drug in treating flare-up of chronic low-back pain: results from two randomized, double-blind, 6-week studies. J Int Med Res. 2009;37(6):1789–802. DOI: http://dx.doi.org/10.1177/147323000903700615.</p><p>Derry S, Moore RA. Single dose oral celecoxib for acute postoperative pain in adults. Cochrane Database Syst Rev. 2012 Mar 14;3:CD004233. DOI: 10.1002/14651858.CD004233.pub3.</p><p>Lain L. Proton pump inhibitor co-therapy with nonsteroidal anti-inflammatory drugs – nice or necessary? Rew Gastroenterol Dis. 2004;4 Suppl 4:33–41.</p><p>Singh G, Triadafilopoulos S. Appropriative choice of proton pump inhibitor therapy in the prevention and management of NSAID-related gastrointestinal damage. Int J Clin Pract. 2005;59(10):1210–5. DOI: http://dx.doi.org/10.1111/j.1368-5031.2005.00660.x.</p><p>Lanas A, Tornero J, Zamorano J. Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study. Ann Rheum Dis. 2010;69(8):1453–8. DOI: http://dx.doi.org/10.1136/ard.2009.123166.</p><p>Conroy RM, Pyorala K, Fitzgerald AP, et al. SCORE project group. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24(11):987–1003. DOI: http://dx.doi.org/10.1016/S0195-668X(03)00114-3.</p><p>Wang P, Avorn J, Brookhart M, et al. Effects of noncardiovascular comorbidities on anti-hypertensive use in elderly hypertensives. Hypertension. 2005;46(2):273–9. DOI: http://dx.doi.org/10.1161/01.HYP.0000172753.96583.e1.</p><p>Aw T, Haas S, Liew D, Krum H. Meta-analysis of cyclooxygenase-2 inhibitorsand their effects on blood pressure. Arch Intern Med. 2005;165(5):490–6. DOI: http://dx.doi.org/10.1001/archinte.165.5.ioi50013.</p><p>Trelle S, Reichenbach S, Wandel S, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011;342:S7086. DOI: 10.1136/bmj.c7086.</p><p>Varas-Lorenzo C, Riera-Guardia N, Calingaert B, et al. Myocardial infarction and individual nonsteroidal anti-inflammatory drugs meta-analysis of observational studies. Pharmacoepidemiol Drug Saf. 2013;22(6):559–70. DOI: 10.1002/pds. Published online 25 April 2013 in Wiley Online Library (wileyonlinelibrary.com)</p><p>Moore R, Derry S, Makinson G, McQuay H. Tolerability and adverse events in clinical trials of celecoxib in osteoarthritis and rheumatoid arthritis: systemic review and meta-analysis on information from company clinical reports. Arthritis Res Ther. 2005;7(3):R644–65. DOI: http://dx.doi.org/10.1186/ar1704. Epub 2005 Mar 24.</p><p>Simon L, Weaver A, Graham D. Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized control trial. JAMA. 1999;282(20):1921–8. DOI: http://dx.doi.org/10.1001/jama.282.20.1921.</p><p>Emery P, Zeidler H, Kvien T, et al. Celecoxib versus diclofenac in long-term management of rheumatoid arthritis: randomized double-blind comparison. Lancet. 1999;354(9106):2106–11. DOI: http://dx.doi.org/10.1016/S0140-6736(99)02332-6.</p><p>Davies N, Saleh J, Skjodt N. Detection and prevention of NSAID-induced enteropathy. J Pharm Pharm Sci. 2000;3(1):137–55.</p><p>Maiden L, Thjodleifsson B, Seigal A, et al. Long-term effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 selective agents on the small bowel: a cross-sectional capsule enteroscopy study. Clin Gastroenterol Hepatol. 2007;5(9):1040–5. DOI: http://dx.doi.org/10.1016/j.cgh.2007.04.031.</p><p>Sands G, Shell B, Zhang R. Adverse events in patients with blood loss: a pooled analysis of 51 clinical studies from the celecoxib clinical trial database. Open Rheumatol J. 2012;6:44–9. DOI: 10.2174/1874312901206010044. Epub 2012 May 11.</p><p>Singh G, Agrawal N, Makinson G, et al. Safety without borders: upper and lower gastrointestinal safety of celecoxib in a pooled analysis of 52 prospective, randomized, double-blinded, parallel-group clinical trials. EULAR-2010 THU0437 .</p><p>Cryer B, Li C, Simon L, et al. GI-REASONS: a novel 6-month, prospective, randomized, open-label, blinded end- point (PROBE) Trial. Am J Gastroenterol. 2012;108(3):392–400. DOI: http://dx.doi.org/10.1038/ajg.2012.467.</p><p>Chan F, Lanas A, Scheiman J, et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet. 2010;376(9736):173–9. DOI: 10.1016/S0140-6736(10)60673-3. Epub 2010 Jun 16.</p><p>Castellsague J, Riera-Guardia N, Calingaert B, et al. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012;35(12):1127–46. DOI: http://dx.doi.org/10.1007/BF03261999.</p><p>Каратеев АЕ. Шесть ножей в спину ингибиторам протонной помпы. Научно-практическая ревматология. 2013;51(3):332-40. [Karateev AE. Six stabs in the back of proton pump inhibitors. Rheumatology Science and Practice. 2013;51(3):332-40.]. DOI: http://dx.doi.org/10.14412/1995-4484-2013-1509.</p><p>Kurth T, Glyn R, Walker A, et al. Inhibition of clinical benefit of aspirin on first myocardial infarction by non-steroidal anti-inflammatory drugs. Circulation. 2003;108(10):1191–5. DOI: http://dx.doi.org/10.1161/01.CIR.0000087593.07533.9B. Epub 2003 Aug 25.</p><p>Hudson M, Baron M, Rahme E, Pilote L. Ibuprofen may abrogate the benefits of aspirin when used for secondary prevention of myocardial infarction. J Rheumatol. 2005;32(8):1589–93.</p><p>Patel T, Goldberg K. Use of aspirin and ibuprofen compared with aspirin alone and the risk of myocardial infarction. Arch Intern Med. 2004;164(8):852–6. DOI: http://dx.doi.org/10.1001/archinte.164.8.852.</p><p>Singh G, Graham D, Wang H, et al. Concominant aspirin use reduces the risk of acute myocardial infarction in users of cyclooxygenase-2 selective and some non-selective nonsteroidal anti-inflammatory drugs. Ann Rheum Dis. 2006;65 (Suppl. II): 61 (OP0024 abst)</p><p>Wilner KD, Rushing M, Walden C, et al. Celecoxib does not affect the antiplatelet activity of aspirin in healthy volunteers. J Clin Pharmacol. 2002 Sep;42(9):1027–30. DOI: http://dx.doi.org/10.1177/009127002401102858.</p><p>Gladding PA, Webster MW, Farrell HB, et al. N. The antiplatelet effect of six non-steroidal anti-inflammatory drugs and their pharmacodynamic interaction with aspirin in healthy volunteers. Am J Cardiol. 2008 Apr 1;101(7):1060–3. DOI: 10.1016/j.amj-card.2007.11.054. Epub 2008 Feb 6.</p><p>Strand V. Are COX-2 inhibitors preferable to non-selective non-steroidal anti-inflammatory drugs in patients with risk of cardiovascular events taking low-dose aspirin? Lancet. 2007;370(9605):2138–51. DOI: http://dx.doi.org/10.1016/S0140-6736(07)61909-6.</p><p>Sheiman J. The use of proton pump inhibitors in treating and preventing NSAID-induced mucosal damage. Arthr Res Ther. 2013;15 Suppl 3:S5. DOI: 10.1186/ar4177. Epub 2013 Jul 24.</p><p>Brooks J, Warburton R, Beales L. Prevention of upper gastrointestinal hemorrhage: current controversies and clinical guidance. Ther Adv Chronic Dis. 2013;4(5):206–22. DOI: 10.1177/2040622313492188.</p><p>Scheiman J, Yeomans N, Talley N, et al. Prevention of ulcer by esomeprazole in at-risk patients using non-selective NSAIDs or COX-2 inhibitor. Am J Gastroenterol. 2006;101(4):701–10. DOI: http://dx.doi.org/10.1111/j.1572-0241.2006.00499.x. Epub 2006 Feb 22.</p><p>Chan F, Wong V, Suen B, et al. Combination of a cyclo-oxygenase-2 inhibitor and a pro-ton-pump inhibitor for prevention of recurrent ulcer bleeding in patients at very high risk: a double-blind, randomised trial. Lancet. 2007;369(9573):1621–6. DOI: http://dx.doi.org/10.1016/S0140-6736(07)60749-1.</p><p>Becker M, Wang T, Wisniewski L, et al. Rationale, design, and governance of Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen Or Naproxen (PRECISION), a cardiovascular end point trial of nonsteroidal antiinflammatory agents in patients with arthritis. Am Heart J. 2009 Apr;157(4):606–12. DOI: 10.1016/j.ahj.2008.12.014. Epub 2009 Feb 25.</p></div><br />


Для цитирования:


Каратеев А.Е. Количественная и качественная оценка риска осложнений при использовании нестероидных противовоспалительных препаратов как основа формирования рекомендаций по их контролю и профилактике. Современная ревматология. 2014;8(1):64-72. https://doi.org/10.14412/1996-7012-2014-1-64-72

For citation:


Karateev A.E. Quantification and qualification of complication risks at use of non-steroid anti-inflammatory drugs as a basis for recommendations on their use and prophylaxis. Modern Rheumatology Journal. 2014;8(1):64-72. (In Russ.) https://doi.org/10.14412/1996-7012-2014-1-64-72

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)