A framework for evaluating the clinical consequences of initial therapy with NSAIDs, NSAIDs plus gastroprotective agents, or celecoxib in the treatment of arthritis.

摘要: Objective: The purpose of this study is to provide a framework for estimating the economic efficiency nonselective nonsteroidal anti-inflammatory drugs (NSAIDs), concomitant gastroprotective agents (GPAs) reduce risk NSAID toxicity, and celecoxib, specific cyclo-oxygenase-2 inhibitor. Concomitant GPAtherapies considered include one following: proton pump inhibitors (PPIs) plus NSAIDs, histamine H2 receptor antagonists (H2RAs) misoprostol single tablet formulation diclofenac/misoprostol. Design: employs decision-tree establish probabilities upper gastrointestinal (GI) adverse events occurring over 6-month time frame. Celecoxib clinical trial data are used GI celecoxib published literature predict other therapies. Upper included in as follows: discomfort, symptomatic ulcer, serious complications (with without death), anaemia with occult bleeding. Main outcome measures results: Clinical indicate has significant tolerability safety advantages compared NSAIDs. also reduces similar or superior degree when reductions observed NSAIDs GPAs. Conclusion: Use expected significantly costs toxicity its associated morbidity.