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MR Vol.13 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.2 |
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Systematic review of NSAID-induced adverse reactions
in patients with rheumatoid arthritis in Japan
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| Tetsuya Tomita1, Takahiro Ochi A1, Kentaro
Sugano , Shinichi Uemura , Robert W. Makuch |
| (1) Department of Orthopedics, Osaka University
Graduate School of Medicine, Osaka Japan |
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| Abstract |
| A systematic review of randomized controlled
clinical trials of nonsteroidal antiinflammatory drugs (NSAIDs)
in rheumatoid arthritis
(RA) patients was conducted to evaluate the risk of NSAID-induced
adverse reactions. Double-blind, randomized, controlled trials
with 6-week treatments for RA patients were included in the study.
The endpoints for the analysis included any adverse reactions,
digestive adverse reactions, and upper gastrointestinal (GI)
adverse reactions. A fixed-effect model was used for estimation
of the risk. Time-to-event analysis of the incidence of adverse
reactions was also conducted. A total of 28 trials was included
for the analysis, and a total of 30 NSAIDs were used in the trials.
The proportion of patients who experienced any adverse reaction
was as follows: piroxicam 18.9% (3 trials), diclofenac 18.8%
(4 trials), indomethacin 22.1% (14 trials), and aspirin 25.0%
(4 trials). The proportion of patients who experienced digestive
adverse reactions was as follows: piroxicam 10.2%, diclofenac
10.6%, indomethacin 13.1%, and aspirin 14.1%. Most withdrawals
due to adverse reaction occurred during the first 3 weeks after
administration of the NSAID. Although the risk of NSAID-induced
adverse reaction was different from drug to drug, the risk of
adverse reaction was clinically significant. |
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