[Cardiovascular and gastrointestinal risks associated with selective and non-selective NSAIDs]. / Cardiovasculaire en gastro-intestinale risico's bij selectieve en niet-selectieve NSAID's.
Ned Tijdschr Geneeskd
; 151(19): 1062-7, 2007 May 12.
Article
em Nl
| MEDLINE
| ID: mdl-17552414
ABSTRACT
There has been much discussion regarding the cardiovascular and gastrointestinal safety of traditional and COX-2 selective NSAIDs. The national and international guidelines differ in their recommendations. Selective COX-2 inhibitors seem to have a diminished risk for severe gastrointestinal complications in the short-term, but the long-term benefit has not yet been proven. In various studies, COX-2 selective NSAIDs have been associated with an increased risk of cardiovascular complications. This connection has been clearly demonstrated only for rofecoxib. Celecoxib seems to lead to an increased risk only at high dosages. However, more patients will have to be followed for a longer period to confirm these results. There is insufficient evidence that the COX-2 selective agents lead to more frequent cardiovascular complications than the traditional NSAIDs. In patients with an increased risk of gastrointestinal complications and no cardiovascular risk, there is no preference for either COX-2 selective NSAIDs or the combination of traditional NSAIDs and a proton pump inhibitor. If dyspepsia develops during the use of a traditional NSAID, then it seems more effective to add a proton-pump inhibitor to the traditional NSAID rather than replacing it by a COX-2 selective NSAID.
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Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Anti-Inflamatórios não Esteroides
/
Inibidores de Ciclo-Oxigenase 2
/
Gastroenteropatias
Tipo de estudo:
Etiology_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Humans
Idioma:
Nl
Ano de publicação:
2007
Tipo de documento:
Article