tailieunhanh - Báo cáo y học: "Distinction from NSAIDs becoming blurred"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Distinction from NSAIDs becoming blurred. | Arthritis Research Therapy Vol 5 No 3 Day Commentary COX-2 Where are we in 2003 Distinction from NSAIDs becoming blurred Richard Day Clinical Pharmacology and Rheumatology St Vincent s Hospital and University of New South Wales Sydney Australia Corresponding author Richard Day e-mail Received 22 Jan 2003 Accepted 7 Feb 2003 Published 27 Feb 2003 Arthritis Res Ther 2003 5 116-119 DOI ar747 2003 BioMed Central Ltd Print ISSN 1478-6354 Online ISSN 1478-6362 Abstract The distinction between cyclooxygenase-2-selective inhibitors CSIs and nonsteroidal antiinflammatory drugs ultimately must be clinical and must be clinically and economically relevant. This distinction needs to be demonstrated in a substantial and clinically relevant difference in the respective rates of serious adverse reactions of the upper gastrointestinal tract. Event-driven randomized blinded controlled trials with sufficient power are required to resolve uncertainties concerning the relative risk of thrombotic cardiovascular events in patients taking CSIs who have risk factors for these events. Patients and situations more representative of those in primary-care practice - elderly comorbidities comedication - need to be included in larger studies to provide a better understanding of the risks and benefits of CSIs. Keywords adverse reactions aspirin hypersensitivity concurrent gastroprotective agents COX-2 selective inhibitors thrombosis Introduction There are several key issues concerning cyclooxygenase-2 COX-2 -selective inhibitors CSIs for 2003 1. What exactly are CSIs and how are they differentiated from nonsteroidal anti-inflammatory drugs NSAIDs 2. Is there a problem concerning the cardiovascular safety of CSIs 3. What is the clinical approach to coprescribing low-dose aspirin and CSIs 4. What is the merit if any of coprescription of gastro-protective agents such as proton-pump inhibitors in patients at high risk of upper gastrointestinal adverse effect from .