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首页> 美国卫生研究院文献>Springer Open Choice >Safety of Oral Non-Selective Non-Steroidal Anti-Inflammatory Drugs in Osteoarthritis: What Does the Literature Say?
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Safety of Oral Non-Selective Non-Steroidal Anti-Inflammatory Drugs in Osteoarthritis: What Does the Literature Say?

机译：骨关节炎中口服非选择性非甾体类抗炎药的安全性：文献怎么说？

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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely recommended and prescribed to treat pain in osteoarthritis. While measured to have a moderate effect on pain in osteoarthritis, NSAIDs have been associated with wide-ranging adverse events affecting the gastrointestinal, cardiovascular, and renal systems. Gastrointestinal toxicity is found with all NSAIDs, which may be of particular concern when treating older patients with osteoarthritis, and gastric adverse events may be reduced by taking a concomitant gastroprotective agent, although intestinal adverse events are not ameliorated. Cardiovascular toxicity is associated with all NSAIDs to some extent and the degree of risk appears to be pharmacotherapy specific. An increased risk of acute myocardial infarction and heart failure is observed with all NSAIDs, while an elevated risk of hemorrhagic stroke appears to be restricted to the use of diclofenac and meloxicam. All NSAIDs have the potential to induce acute kidney injury, and patients with osteoarthritis with co-morbid conditions including hypertension, heart failure, and diabetes mellitus are at increased risk. Osteoarthritis is associated with excess mortality, which may be explained by reduced levels of physical activity owing to lower limb pain, presence of comorbid conditions, and the adverse effects of anti-osteoarthritis medications especially NSAIDs. This narrative review of recent literature identifies data on the safety of non-selective NSAIDs to better understand the risk:benefit of using NSAIDs to manage pain in osteoarthritis.
机译：广泛推荐使用非甾体抗炎药（NSAIDs）来治疗骨关节炎的疼痛。尽管经测定对骨关节炎疼痛具有中等作用，但非甾体抗炎药已与影响胃肠，心血管和肾系统的广泛不良事件有关。所有NSAIDs均具有胃肠道毒性，这在治疗老年骨关节炎患者时尤其值得关注，尽管未减轻肠道不良反应，但服用胃肠保护药可减轻胃部不良反应。心血管毒性在一定程度上与所有NSAID相关，并且危险程度似乎是药物治疗特异性的。使用所有NSAID均可观察到急性心肌梗塞和心力衰竭的风险增加，而出血性中风的风险升高似乎仅限于双氯芬酸和美洛昔康的使用。所有非甾体抗炎药都有诱发急性肾损伤的潜力，患有合并症的骨关节炎患者，包括高血压，心力衰竭和糖尿病，患病风险增加。骨关节炎与死亡率过高有关，其原因可能是下肢疼痛，合并症和抗骨关节炎药物（尤其是非甾体抗炎药）的不良影响导致体育活动水平降低。这篇有关最近文献的叙述性综述确定了非选择性NSAIDs安全性的数据，以更好地了解风险：使用NSAIDs治疗骨关节炎疼痛的益处。

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