Uso apropiado de los antiinflamatorios no esteroideos en reumatología: documento de consenso de la Sociedad Española de Reumatología y el Colegio Mexicano de Reumatología

Segura, Gerardo Bori; Cruz, Blanca Hernández; Gobbo, Milena; Arbeloa, Ángel Lanas; Páramo, Mario Salazar; Estrada, Leobardo Terán; González, Julia; Morales, Rolando Espinosa; Villegas, Federico Galván; Rodrı́guez, Luis A. Garcı́a; Álvaro, José María Álvaro-Gracia; Armengol, Hilario Ávila; Carmona, Loreto; Redondo, Javier Rivera; Ríos, Lucio Ventura

doi:10.1016/s1699-258x(09)70197-4

Cited by 26 publications

(5 citation statements)

References 29 publications

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“…Based on these findings, the Food and Drug Administration (FDA) [10], the European Medicines Agency (EMA) [11], and different scientific societies [12-14] agree that the medical management of patients who require NSAIDs must be based upon the previous assessment of GI and CV risk factors in the individual patient. Guidelines recommend the use of nsNSAIDs plus a gastroprotectant or a COX-2-selective NSAID alone in patients with one or more GI risk factors [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis

Lanas

Garcia-Tell

Armada

et al. 2011

BMC Med

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BackgroundPrescription of non-steroidal anti-inflammatory drugs (NSAIDs) should be based on the assessment of both gastrointestinal (GI) and cardiovascular (CV) risk for the individual patient. We aimed to assess the GI/CV risk profile and the pharmacological management of patients with osteoarthritis (OA) in clinical practice.MethodsWe conducted a cross-sectional, multicentre, observational study of consecutive OA patients that visited 1,760 doctors throughout the Spanish National Health System (NHS) in a single day. The presence of GI risk factors, CV histories, hypertension and current pharmacological treatments was recorded.ResultsOf the 60,868 patients, 17,105 had a diagnosis of OA and were evaluable. The majority (93.4%) had more than one GI risk factor and 60.3% were defined to be at high-GI risk. Thirty-two percent had a history of CV events, 57.6% were treated with anti-hypertensive therapy and 22.6% had uncontrolled hypertension. One-fifth of patients were treated with non-NSAID therapies, whereas the remaining patients received NSAIDs. Non-selective NSAIDs (nsNSAID) plus proton pump inhibitor (PPI) or cyclooxigenase-2 (COX-2)-selective NSAIDs alone were more frequently prescribed in patients at increased GI risk. Patients with a positive CV history received nsNSAIDs or COX-2-selective NSAIDs in 41.3% and 31.7% of cases, respectively. When both the GI and CV histories were combined, 51% of the overall population was being prescribed drugs that were either not recommended or contraindicated.ConclusionsOver 90% of patients with OA are at increased GI and/or CV risk. In over half of these patients, the prescription of NSAIDs was not in accordance with current guidelines or recommendations made by regulatory agencies.

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Section: Introductionmentioning

confidence: 99%

“…Therefore, our study was aimed at evaluating the GI and CV risk profiles in patients with OA as well as the pharmacological management and the appropriateness of therapies based on current recommendations issued by European guidelines and the European Medicines Agency [11,12,14,16]. …”

Section: Introductionmentioning

confidence: 99%

Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis

Lanas

Garcia-Tell

Armada

et al. 2011

BMC Med

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“…Según éste, se consideran como factores de riesgo GI: el antecedente de úlcera gastroduodenal (UGD) complicada o no complicada, el uso de ACO, edad >65 años, el uso concomitante de más de un AINE (incluyendo Aspirina a bajas dosis), tratamiento con dosis altas de AINES y duración prolongada del mismo. Se consideran pacientes con alto riesgo GI aquellos con antecedente de UGD complicada o que utilizan ACO o que presenten más de dos factores de riesgo; pacientes con moderado riesgo GI aquellos que presenten un factor de riesgo (que no incluya ninguno de los mencionados previamente) y bajo riesgo GI aquellos sin factores de riesgo 4 . Es importante mencionar la indicación en dicho Consenso de utilizar IBP en aquellos pacientes que refieren antecedente de dispepsia relacionada con el uso de AINES.…”

Section: Materiales Y Métodosunclassified

Consumo de antiinflamatorios no esteroideos en pacientes que concurren por primera vez a un Servicio de Reumatología

Cruz

Medina

Papasidero

et al. 2014

Rev. Argent. Reumatol.

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Introducción: el uso de antiinflamatorios no esteroideos (AINES) conlleva una mayor probabilidad de enfermedad gastrointestinal y cardiovascular en pacientes con factores de riesgo. Por tal motivo, se desarrollaron diversas recomendaciones con el fin de prevenir dichas complicaciones. Objetivo: Evaluar la frecuencia del consumo de AINES al momento de consultar por primera vez a un Servicio de Reumatología de demanda espontánea; y analizar tanto la conducta del médico así como el correcto cumplimiento de las recomendaciones para la toma de estos fármacos al finalizar la consulta. Material y métodos: Estudio observacional de corte transversal. Resultados: Se incluyeron 304 pacientes, 59,5% consumían AINES. La mayoría de estos pacientes presentaban riesgo gastrointestinal moderado/alto, sólo 28,3% recibían adecuada protección. De aquellos pacientes que recibían AINES, se consideró que requerían dicho tratamiento el 50%. Al finalizar la consulta, se tomó una conducta correcta en el 89% de los casos en relación al riesgo gastrointestinal. Conclusión: Más de la mitad de los pacientes consumían AINES. Se observó un buen cumplimiento de las recomendaciones por los médicos tratantes al finalizar la primera consulta. Sin embargo, es importante mencionar que el uso indiscriminado de AINES tanto por parte de los pacientes como por parte de los médicos sigue siendo alto.

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“…They are used to decrease pain and inflammation caused by various diseases, such as in the treatment of arthritis. 8 However, the continuous use of NSAIDs is directly associated with gastrointestinal, cardiovascular and renal complications. NSAID-related morbidity and mortality are well known in the scientific community.…”

Section: Introductionmentioning

confidence: 99%

“…For that reason, there is a recommendation to use these drugs in the lowest effective dose and for the shortest possible time. [8][9][10][11] This study was aimed at producing and assessing anti-inflammatory activity of an implantable system for sodium diclofenacdelivery in an articular joint to promote drug activity at lower doses than those used orally, thus reducing unwanted side effects.…”

Section: Introductionmentioning

confidence: 99%

Dispositivo implantável de EUDRAGIR/PCL-T/ Diclofenaco de sódio: caracterização mecânica, liberação do fármaco e atividade anti-inflamatóriain vivo

Cunha¹,

Moterle²,

Cunha³

et al. 2016

Medicina (Ribeirão Preto)

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Modelo do estudo: experimental. Objetivo do estudo: produzir, descrever e avaliar a atividade antiinflamatória de um sistema polimérico implantável contendo diclofenaco de sódio na inflamação aguda induzida por carragenina em um modelo de artrite emjoelho de ratos. Metodologia: Um dispositivo implantável de Eudragit RS 100 e PCL-T (EUDPCL-T) contendo 3.0 mg de diclofenaco de sódio foi produzido. Os dispositivos foram implantados na região peri-articular posterior dos joelhos de ratos induzidos a artrite. Resultados: Após 6 horas e no dia 7 após a indução de artrite, o edema do joelho foi avaliado, e os mediadores inflamatórios, mieloperoxidase (MPO) e óxido nítrico foram analisados. Os resultados foram comparados com a administração oral de 30 mg / kg de diclofenaco de sódio. Conclusões: O dispositivo implantável foi capaz de produzir os mesmos resultados anti-inflamatórios na artrite induzida por carragenina quando comparadoscom o tratamento por via oral, entretanto com doses mais baixas

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Uso apropiado de los antiinflamatorios no esteroideos en reumatología: documento de consenso de la Sociedad Española de Reumatología y el Colegio Mexicano de Reumatología

Cited by 26 publications

References 29 publications

Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis

Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis

Consumo de antiinflamatorios no esteroideos en pacientes que concurren por primera vez a un Servicio de Reumatología

Dispositivo implantável de EUDRAGIR/PCL-T/ Diclofenaco de sódio: caracterização mecânica, liberação do fármaco e atividade anti-inflamatóriain vivo

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