The Cardiovascular Pharmacology of Nonsteroidal Anti-Inflammatory Drugs

被引：157

作者：

Grosser, Tilo ^{[1
]}

Ricciotti, Emanuela ^{[1
]}

FitzGerald, Garret A. ^{[1
]}

机构：

[1] Univ Penn, Perelman Sch Med, Inst Translat Med & Therapeut, Philadelphia, PA 19104 USA

来源：

TRENDS IN PHARMACOLOGICAL SCIENCES | 2017年 / 38卷 / 08期

关键词：

LOW-DOSE ASPIRIN; CONTROLLED-RELEASE TABLET; NITRIC-OXIDE SYNTHASE; PHARMACODYNAMIC INTERACTION; CYCLOOXYGENASE INHIBITORS; SELECTIVE INHIBITORS; NAPROXEN; PHARMACOKINETICS; PROSTACYCLIN; PLATELET;

D O I：

10.1016/j.tips.2017.05.008

中图分类号：

R9 [药学];

学科分类号：

100702 [药剂学];

摘要：

The principal molecular mechanisms underlying the cardiovascular (CV) and renal adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs), such as myocardial infarction and hypertension, are understood in more detail than most side effects of drugs. Less is known, however, about differences in the CV safety profile between chemically distinct NSAIDs and their relative predisposition to complications. In review article, we discuss how heterogeneity in the pharmacokinetics and pharmacodynamics of distinct NSAIDs may be expected to affect their CV risk profile. We consider evidence afforded by studies in model systems, mechanistic clinical trials, a meta-analysis of randomized controlled trials, and two recent large clinical trials, Standard Care vs. Celecoxib Outcome Trial (SCOT) and Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen (PRECISION), designed specifically to compare the CV safety of the cyclooxygenase-2-selective NSAID, celecoxib, with traditional NSAIDs. We conclude that SCOT and PRECISION have apparently not compared equipotent doses and have other limitations that bias them toward underestimation of the relative risk of celecoxib.

引用

页码：733 / 748

页数：16

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