老年患者静脉注射布洛芬的安全性和有效性：回顾性亚组分析。

IF 3.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2025-05-27 DOI:10.1016/j.clinthera.2025.04.021

Tong J. Gan MD , Breanne Gibson PhD , Emily Durr PharmD , Andrew Abad PhD , Beth Zaborny , Sergio Bergese MD , Stephen Southworth MD

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引用次数: 0

摘要

目的：静脉注射布洛芬（IVIB）对于儿童和成人疼痛和发烧的治疗是安全有效的，但需要对老年患者进行评估。本回顾性研究旨在评估IVIB在老年患者（年龄≥60岁）中的安全性和有效性。方法：对四项前瞻性临床研究的数据进行事后亚组分析，在这些研究中，每6小时给药IVIB治疗住院患者的疼痛和/或发热，持续5天。采用吗啡总需氧量和视觉模拟量表评估疼痛。通过不良事件（AE）监测评估安全性。结果：1041例患者中，757例患者年龄在18 - 59岁之间，284例患者年龄≥60岁。在老年患者中，61人接受安慰剂治疗，223人接受IVIB治疗。所有患者均纳入安全性评估；来自两项安慰剂对照试验的591例患者被纳入疗效分析。在两个年龄组中，安慰剂组的不良事件发生率较高，两组之间严重不良事件的发生率相似。在老年患者中，IVIB治疗导致术后6至24小时内休息时疼痛减少24.0% (P = 0.008)，运动时疼痛减少20.0% (P = 0.001)，与安慰剂相比，吗啡总需求量减少23.2% （P = 0.031）。意义：IVIB耐受性良好，可减少老年患者术后阿片类药物消耗和疼痛严重程度。这些发现表明，IVIB是一种安全有效的非阿片类镇痛药，用于老年人围手术期疼痛管理。

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The Safety and Efficacy of Intravenous Ibuprofen in Older Patients: A Retrospective Subgroup Analysis

Purpose

Intravenous ibuprofen (IVIB) is safe and effective for the management of pain and fever in children and adults, but requires evaluation in older patients. This retrospective study aimed to evaluate the safety and efficacy of IVIB in older patients (age ≥60 years).

Methods

A post hoc subgroup analysis was performed with data from four prospective clinical studies in which IVIB was administered for the treatment of pain and/or fever in hospitalized patients every 6 hours for up to 5 days. Efficacy was assessed using total morphine requirement and the visual analogue scale to evaluate pain. Safety was assessed by adverse event (AE) monitoring.

Findings

Of 1041 patients treated, 757 patients were 18 to 59 years old and 284 were ≥60 years old. Among older patients, 61 received placebo, and 223 received IVIB. All patients were included in the safety assessment; 591 patients from two placebo-controlled trials were included in the efficacy analysis. In both age cohorts, the incidence of AEs was higher in the placebo group, and the incidence of serious AEs was similar between treatment groups. In older patients, IVIB treatment resulted in a 24.0% reduction in pain at rest (P = 0.008), a 20.0% reduction in pain with movement (P = 0.001) between 6 and 24 hours postsurgery, and a 23.2% reduction in total morphine requirement (P = 0.031) compared with placebo.

Implications

IVIB was well-tolerated and reduced postoperative opioid consumption and pain severity in older patients. These findings suggest IVIB is a safe and effective nonopioid analgesic for perioperative pain management in older individuals.

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.