Medicus, Vol. 13 No. 1_Depresija, 2004.
Pregledni rad
Evidence Based Medicine: Recommendations for Pharmacological Treatment of Osteoarthritis Patients
Branko Kopjar
Božidar Ćurković
Simeon Grazio
Tonko Vlak
Sažetak
Non-steroidal anti-inflammatory drugs
(NSAIDs) are the treatment of choice for pain control in
patients with osteoarthritis (OA). Numerous NSAIDs are available
on the market, making a clinical choice difficult.
Objective: to review three types of data related to NSAIDs
(research results, clinical experience and costs) and thus
assist in a clinical decision-making process.
Materials and methods: We searched Cochrane, Medline and
Embase for systematic reviews and randomized controlled trials
about clinical efficacy and side effects of NSAIDs. Clinical
experience is based on the opinion of clinicians, i.e. the coauthors
of this paper. Costs and sales statistics were
obtained for the Croatian drug market.
Results: All NSAIDs, including the new selective COX-2
inhibitors, have similar efficacy in controlling the OA pain. Toxicity
on upper gastrointestinal tract is the lowest for
diclofenac and ibuprofen, whilst for selective COX-2
inhibitors, although probably lower, has not been fully established.
Other side effects are rarely clinically relevant and
they have not been elucidated for COX-2 inhibitors. There is a
long-term favorable clinical experience with the use of
diclofenac and ibuprofen. The costs are the lowest for
diclofenac, while COX-2 inhibitors are much more expensive
than non-selective NSAIDs.
Conclusion: Diclofenac, followed by ibuprofen, remains the
drug of choice in the pharmacological treatment of OA
patients.
Ključne riječi
non-steroidal anti-inflammatory drugs; osteoarthritis
Hrčak ID:
19816
URI
Datum izdavanja:
26.1.2004.
Posjeta: 2.260 *