Alimentary Pharmacology & Therapeutics Symposium Series最新文献_第7页

Panel discussion: treatment approaches to control gastrointestinal risk and balance cardiovascular risks and benefits: proposals and recommendations 小组讨论:控制胃肠道风险和平衡心血管风险和益处的治疗方法:提案和建议

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00018.x

J. M. SCHEIMAN, B. CRYER, M. ASAKA, F. BERENBAUM, J. BONNET, F. K.-L. CHAN, G. KREJS, A. LANAS, A. WEAVER, F. ZERBIB

引用次数: 4

Chairmen's introduction 主席的介绍

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00011.x

J. M. Scheiman, B. Cryer

引用次数: 0

Review article: a cardiologist's view of the risks and benefits of cyclo-oxygenase-2 inhibitors, aspirin and other non-steroidal anti-inflammatory drugs 综述文章:心脏病专家对环氧化酶-2抑制剂、阿司匹林和其他非甾体抗炎药的风险和益处的看法

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00014.x

J. BONNET

{"title":"Review article: a cardiologist's view of the risks and benefits of cyclo-oxygenase-2 inhibitors, aspirin and other non-steroidal anti-inflammatory drugs","authors":"J. BONNET","doi":"10.1111/j.1746-6342.2005.00014.x","DOIUrl":"10.1111/j.1746-6342.2005.00014.x","url":null,"abstract":"Cyclo-oxygenase-2 inhibitors are very interesting drugs, capable of inhibiting, the main source of inflammatory prostaglandins in the joint while also avoiding gastrointestinal complications. Unfortunately, double-blind studies have clearly demonstrated that cyclo-oxygenase-2 agents increase cardiovascular risk. This phenomenon appears to be a class effect although it seems to be less pronounced with celecoxib. These adverse cardiovascular events are mainly due to an elevated thrombotic risk and are possibly linked to the increase in blood pressure. The decision about whether to continue with cyclo-oxygenase-2 treatment can only be undertaken after consideration of both the cardiovascular risk and the gastrointestinal risk of an individual patient. In contrast, low-dose aspirin continues to be the simplest and most effective way to prevent cardiovascular disease. However, the increased risk of adverse gastrointestinal events associated with aspirin use, such as gastrointestinal bleeding and intracerebral bleeding, must not be forgotten. Ideally, the prescription of low-dose aspirin should be avoided for low cardiovascular risk patients and reserved for those patients with high or intermediate cardiovascular risk. In these patients, the risk of gastrointestinal events should prompt the prescription of a gastroprotectant, such as a proton-pump inhibitor, to be taken concomitantly, which will help avoid the significant problem of non-compliance in high cardiovascular risk patients.","PeriodicalId":50822,"journal":{"name":"Alimentary Pharmacology & Therapeutics Symposium Series","volume":"1 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2005-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1746-6342.2005.00014.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"103986575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Review article: clinical management of non-steroidal anti-inflammatory drug and cyclo-oxygenase-2 inhibitor users: a European perspective 综述文章:非甾体抗炎药和环氧化酶-2抑制剂使用者的临床管理:欧洲视角

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00013.x

F. BERENBAUM

{"title":"Review article: clinical management of non-steroidal anti-inflammatory drug and cyclo-oxygenase-2 inhibitor users: a European perspective","authors":"F. BERENBAUM","doi":"10.1111/j.1746-6342.2005.00013.x","DOIUrl":"10.1111/j.1746-6342.2005.00013.x","url":null,"abstract":"<div>\u0000 \u0000 <p>Following the withdrawal of rofecoxib from the market in September 2004, the European Medicines Evaluation Agency's prescribing recommendations for cyclo-oxygenase-2 inhibitors were quite similar to those issued by the US Food and Drug Administration. Prior to this event the perceptions and guidelines for use of cyclo-oxygenase-2 agents varied between the different countries, however the cardiovascular concerns that were raised about the cyclo-oxygenase-2 inhibitor class prompted a dramatic shift in perception and a significant switch to the use of traditional non-steroidal anti-inflammatory drugs.</p>\u0000 <p>There is little doubt that non-steroidal anti-inflammatory drugs are effective in relieving pain and inflammation in conditions such as rheumatoid arthritis and osteoarthritis, however they are known to be associated with gastrointestinal adverse events. In order to avoid these gastrointestinal risks, the clinician may choose to prescribe an analgesic agent such as paracetamol as an alternative, or add a gastroprotective agent, such as a proton-pump inhibitor to the non-steroidal anti-inflammatory drug therapy. Whether the patient takes aspirin also needs to be considered: while aspirin is often taken for prophylaxis against cardiovascular events, it is itself associated with gastrointestinal risks and has been shown to eliminate the gastrointestinal sparing effects of cyclo-oxygenase-2 agents.</p>\u0000 <p>In the light of this evidence many national rheumatology societies in Europe have now issued recommendations for the use of cyclo-oxygenase-2 inhibitors and conventional non-steroidal anti-inflammatory drugs based on the patient's individual risk profile.</p>\u0000 </div>","PeriodicalId":50822,"journal":{"name":"Alimentary Pharmacology & Therapeutics Symposium Series","volume":"1 1","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2005-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1746-6342.2005.00013.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"102180343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review article: low-dose aspirin, non-steroidal anti-inflammatory drugs and cyclo-oxygenase inhibitors – balancing risks and benefits 综述文章:低剂量阿司匹林，非甾体抗炎药和环加氧酶抑制剂-平衡风险和收益

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00016.x

F. K.-L. CHAN

{"title":"Review article: low-dose aspirin, non-steroidal anti-inflammatory drugs and cyclo-oxygenase inhibitors – balancing risks and benefits","authors":"F. K.-L. CHAN","doi":"10.1111/j.1746-6342.2005.00016.x","DOIUrl":"10.1111/j.1746-6342.2005.00016.x","url":null,"abstract":"<div>\u0000 \u0000 <p>In recent years, there has been a rapid increase in the number of patients using aspirin for the prevention of cardiovascular events and also other non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, for the treatment of arthritis. However, aspirin and non-steroidal anti-inflammatory drugs are associated with an increase in gastrointestinal risk. Recent studies have shown that cyclo-oxygenase-2 inhibitors, and possibly non-selective non-steroidal anti-inflammatory drugs, increase the cardiovascular risk.</p>\u0000 <p>In patients taking aspirin, the ‘gold standard’ therapy to reduce gastrointestinal risk is concomitant therapy with a gastroprotective agent, such as a proton-pump inhibitor. Other gastroprotective agents, such as misoprostol, while equally effective may be associated with a higher proportion of adverse events. <i>Helicobacter pylori</i> infection has been shown to increase the risk of upper gastrointestinal bleeding associated with low-dose aspirin. Emerging data suggest that the eradication of <i>H. pylori</i> reduces the gastrointestinal risk of high-risk aspirin users. Other antiplatelet agents such as clopidogrel that were thought to be non-ulcerogenic have been widely used as alternatives to aspirin. However, recent studies have shown that clopidogrel induces an unacceptably high rate of ulcer bleeding in high-risk patients.</p>\u0000 <p>When prescribing non-steroidal anti-inflammatory drugs therapy, treatment needs to be individualized according to the patients’ gastrointestinal and cardiovascular risk factors.</p>\u0000 </div>","PeriodicalId":50822,"journal":{"name":"Alimentary Pharmacology & Therapeutics Symposium Series","volume":"1 1","pages":"20-23"},"PeriodicalIF":0.0,"publicationDate":"2005-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1746-6342.2005.00016.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"100492533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review article: aspirin, non-steroidal anti-inflammatory drugs and cyclo-oxygenase-1 sparing agents 综述文章:阿司匹林，非甾体抗炎药和环氧化酶-1保留剂

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00012.x

A. L. WEAVER

{"title":"Review article: aspirin, non-steroidal anti-inflammatory drugs and cyclo-oxygenase-1 sparing agents","authors":"A. L. WEAVER","doi":"10.1111/j.1746-6342.2005.00012.x","DOIUrl":"10.1111/j.1746-6342.2005.00012.x","url":null,"abstract":"<div>\u0000 \u0000 <p>Until recently, cyclo-oxygenase-2 inhibitors were one of the mainstays of therapy for patients with osteoarthritis and rheumatoid arthritis because of their improved gastrointestinal safety profile compared with traditional, non-selective non-steroidal anti-inflammatory drugs.</p>\u0000 <p>The withdrawal of both rofecoxib and valdecoxib from the market because of concerns about cardiovascular risk has prompted a re-evaluation of treatment choices for arthritis patients who require treatment with non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs, both prescription and over-the-counter, are widely used in the USA. Patients often take several agents concurrently which significantly increases their risk of gastrointestinal adverse events. In addition, many patients also take low-dose aspirin because of its proven beneficial effects in the prevention of cardiovascular events. However, large clinical trials have shown that the concomitant use of aspirin negates the gastrointestinal-sparing effects of selective cyclo-oxygenase-2 inhibitors.</p>\u0000 <p>Clinicians need to consider a patient's cardiovascular and gastrointestinal risks when prescribing non-steroidal anti-inflammatory drugs, and in the case of non-selective non-steroidal anti-inflammatory drugs, gastroprotection with an agent such as a proton-pump inhibitor or misoprostol should be considered, particularly in aspirin users.</p>\u0000 </div>","PeriodicalId":50822,"journal":{"name":"Alimentary Pharmacology & Therapeutics Symposium Series","volume":"1 1","pages":"2-5"},"PeriodicalIF":0.0,"publicationDate":"2005-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1746-6342.2005.00012.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132599065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Review article: a summary of studies of non-steroidal anti-inflammatory drug-induced gastrointestinal complications in Japanese patients 综述文章:日本患者非甾体抗炎药引起的胃肠道并发症的研究综述

Alimentary Pharmacology & Therapeutics Symposium Series Pub Date : 2005-08-26 DOI: 10.1111/j.1746-6342.2005.00017.x

M. ASAKA

引用次数: 0