Thanh bên bài viết
Số lượt xem PDF: 42
NSAID PRESCRIPTION SURVEY IN INTEGRATED TRADITIONAL AND WESTERN MEDICINE TREATMENT: ASSESSING GASTROINTESTINAL AND CARDIOVASCULAR RISKS
Nội dung chính của bài viết
Tóm tắt
Introduction: Non-steroidal anti-inflammatory drug (NSAID) usage should be carefully considered based on gastrointestinal (GI) and cardiovascular (CV) risks. In light of restricted evidence, this study aims to assess the prescription of NSAIDs concerning the GI and CV risks in the integrated treatment of Traditional medicine (TM) and Western medicine (WM). Materials and method: A retrospective cross-sectional study was conducted on 393 medical records of inpatients using NSAIDs in 2022 at the Traditional Medicine Hospital of Ho Chi Minh City. GI and CV risks, as well as information regarding NSAID prescriptions, were recorded. A multivariable regression model was employed to identify factors associated with the prescription of NSAID groups. Results: NSAIDs were primarily prescribed for musculoskeletal and connective tissue disorders (87.28%). Approximately half of the cases exhibited moderate to high GI risk (47.59%), while for CV risk, there were 68.95% with moderate to very high risk. COX-2 inhibitors were the most commonly prescribed (94.66%), even when considering GI and CV risks separately. In the majority, NSAID prescriptions aligned with both risks according to American College of Gastroenterology (ACG) guidelines (73.79%). The prescription of NSAID groups was significantly influenced by patient gender, ailment type, and physician education (p<0.05), but not by GI and CV risks (p>0.05). Conclusion: Patients receiving NSAIDs in integrated TM and WM treatment often faced an increased GI and CV risk, with the majority adhering to ACG guidelines. However, GI and CV risks were not significantly considered for NSAID group selections. Multi-center studies should be conducted.
Chi tiết bài viết
Từ khóa
NSAID, gastrointestinal risk, cardiovascular risk, traditional medicine, integrative medicine
Tài liệu tham khảo
2. FDA. Nonsteroidal Anti-inflammatory Drugs (NSAIDs) 2020 [cited 2023 May 7th]. Available from: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/nonsteroidal-anti-inflammatory-drugs-nsaids.
3. EMEA. European Medicines Agency review concludes positive benefit-risk balance for non-selective NSAIDs 2006 [cited 2023 May 7th]. Available from: https://www.ema.europa.eu/en/documents/press-release/european-medicines-agency-review-concludes-positive-benefit-risk-balance-non-selective-nsaids_en.pdf.
4. Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP, et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005;64(5):669-81. doi: 10.1136/ard.2004.028886.
5. Bori Segura G, Hernández Cruz B, Gobbo M, Lanas Arbeloa A, Salazar Páramo M, Terán Estrada L, et al. [Appropriate use of non-steroidal anti-inflammatory drugs in rheumatology: guidelines from the Spanish Society of Rheumatology and the Mexican College of Rheumatology]. Reumatol Clin. 2009;5(1):3-12. doi: 10.1016/s1699-258x(09)70197-4.
6. American College of Rheumatology. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum. 2000;43(9):1905-15. doi: 10.1002/1529-0131(200009)43:9<1905::Aid-anr1>3.0.Co;2-p.
7. Lanas A, Garcia-Tell G, Armada B, Oteo-Alvaro A. Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis. BMC Med. 2011;9:38. doi: 10.1186/1741-7015-9-38.
8. Wang C, Meng Q. Global Research Trends of Herbal Medicine for Pain in Three Decades (1990-2019): A Bibliometric Analysis. J Pain Res. 2021;14:1611-26. doi: 10.2147/jpr.S311311
9. Du GH, Yuan TY, Du LD, Zhang YX. The Potential of Traditional Chinese Medicine in the Treatment and Modulation of Pain. Adv Pharmacol. 2016;75:325-61. doi: 10.1016/bs.apha.2016.01.001
10. Sharma A, Minh Duc NT, Luu Lam Thang T, Nam NH, Ng SJ, Abbas KS, et al. A Consensus-Based Checklist for Reporting of Survey Studies (CROSS). J Gen Intern Med. 2021;36(10):3179-87. doi: 10.1007/s11606-021-06737-1
11. Lanza FL, Chan FKL, Quigley EMM. Practice Parameters Committee of the American College of Gastroenterology. Guidelines for Prevention of NSAID-Related Ulcer Complications. Official journal of the American College of Gastroenterology | ACG. 2009;104(3).
12. ESC/EAS. 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019;290:140-205. doi: 10.1016/j.atherosclerosis.2019.08.014
13. Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121-6. doi: 10.4103/0253-7176.116232
14. Atchison JW, Herndon CM, Rusie E. NSAIDs for musculoskeletal pain management:current perspectives and novel strategies to improve safety. J Manag Care Pharm. 2013;19(9 Suppl A):S3-19.
15. Burmester GR, Bijlsma JWJ, Cutolo M, McInnes IB. Managing rheumatic and musculoskeletal diseases - past, present and future. Nat Rev Rheumatol. 2017;13(7):443-8. doi: 10.1038/nrrheum.2017.95
16. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81(9):646-56.
17. Quicke JG, Conaghan PG, Corp N, Peat G. Osteoarthritis year in review 2021: epidemiology & therapy. Osteoarthritis Cartilage. 2022;30(2):196-206. doi: 10.1016/j.joca.2021.10.003.
18. Farkouh A, Baumgärtel C, Gottardi R, Hemetsberger M, Czejka M, Kautzky-Willer A. Sex-Related Differences in Drugs with Anti-Inflammatory Properties. J Clin Med. 2021;10(7). doi: 10.3390/jcm10071441
19. Domper Arnal MJ, Hijos-Mallada G, Lanas A. Gastrointestinal and cardiovascular adverse events associated with NSAIDs. Expert Opin Drug Saf. 2022;21(3):373-84. doi: 10.1080/14740338.2021.1965988
20. Cryer B, Li C, Simon LS, Singh G, Stillman MJ, Berger MF. GI-REASONS: a novel 6-month, prospective, randomized, open-label, blinded endpoint (PROBE) trial. Am J Gastroenterol. 2013;108(3):392-400. doi: 10.1038/ajg.2012.467
21. Burmester G, Lanas A, Biasucci L, Hermann M, Lohmander S, Olivieri I, et al. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. Ann Rheum Dis. 2011;70(5):818-22. doi: 10.1136/ard.2010.128660
22. Chan FK, Abraham NS, Scheiman JM, Laine L. Management of patients on nonsteroidal anti-inflammatory drugs: a clinical practice recommendation from the First International Working Party on Gastrointestinal and Cardiovascular Effects of Nonsteroidal Anti-inflammatory Drugs and Anti-platelet Agents. Am J Gastroenterol. 2008;103(11):2908-18. doi: 10.1111/j.1572-0241.2008.02200.x
23. Koffeman AR, Valkhoff VE, Jong GW, Warlé-van Herwaarden MF, Bindels PJ, Sturkenboom MC, et al. Ischaemic cardiovascular risk and prescription of non-steroidal anti-inflammatory drugs for musculoskeletal complaints. Scand J Prim Health Care. 2014;32(2):90-8. doi: 10.3109/02813432.2014.929810
24. Bonnesen K, Schmidt M. Recategorization of Non-Aspirin Nonsteroidal Anti-inflammatory Drugs According to Clinical Relevance: Abandoning the Traditional NSAID Terminology. Can J Cardiol. 2021;37(11):1705-7. doi: 10.1016/j.cjca.2021.06.014
25. McGettigan P, Henry D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med. 2011;8(9):e1001098. doi: 10.1371/journal.pmed.1001098
26. Trelle S, Reichenbach S, Wandel S, Hildebrand P, Tschannen B, Villiger PM, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. Bmj. 2011;342:c7086. doi: 10.1136/bmj.c7086
27. Phueanpinit P, Pongwecharak J, Sumanont S, Krska J, Jarernsiripornkul N. Physicians' communication of risks from non-steroidal anti-inflammatory drugs and attitude towards providing adverse drug reaction information to patients. J Eval Clin Pract. 2017;23(6):1387-94. doi: 10.1111/jep.12806
28. Ho KY. Perceptions and Beliefs Regarding NSAIDs in the Asia-Pacific Region. J Pain Res. 2020;13:437-46. doi: 10.2147/jpr.S229387
29. Neutel CI, Maxwell CJ, Appel WC. Differences between males and females in risk of NSAID-related severe gastrointestinal events. Pharmacoepidemiol Drug Saf. 1999;8(7):501-7. doi: 10.1002/(sici)1099-1557(199912)8:7<501::Aid-pds454>3.0.Co;2-y.