Systematic Review on the Safety of Concomitant Use of Hypoglycemia-Inducing Drugs and Non-Steroidal Anti-Inflammatory Drugs in Patients With Musculoskeletal Pathology
Revisión sistemática sobre la seguridad del uso concomitante de fármacos hipoglucemiantes y antiinflamatorios no esteroideos en pacientes con enfermedad reumática
Estíbaliz Loza
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eloza.hcsc@salud.madrid.org
Correspondence: Hospital Clínico San Carlos. Prof. Martín Lagos, s/n. 28015 Madrid. España.
Correspondence: Hospital Clínico San Carlos. Prof. Martín Lagos, s/n. 28015 Madrid. España.
Servicio de Reumatología, Hospital Clínico San Carlos, Madrid, Spain
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"https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574308701953?idApp=UINPBA00004M" "url" => "/21735743/0000000400000006/v1_201305061550/S2173574308701953/v1_201305061550/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "titulo" => "Systematic Review on the Safety of Concomitant Use of Hypoglycemia-Inducing Drugs and Non-Steroidal Anti-Inflammatory Drugs in Patients With Musculoskeletal Pathology" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "232" "paginaFinal" => "239" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Estíbaliz Loza" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Estíbaliz" "apellidos" => "Loza" "email" => array:1 [ 0 => "eloza.hcsc@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Reumatología, Hospital Clínico San Carlos, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Hospital Clínico San Carlos. Prof. Martín Lagos, s/n. 28015 Madrid. España." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Revisión sistemática sobre la seguridad del uso concomitante de fármacos hipoglucemiantes y antiinflamatorios no esteroideos en pacientes con enfermedad reumática" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-05-14" "fechaAceptado" => "2008-07-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec111940" "palabras" => array:3 [ 0 => "Non-steroidal anti-inflammatory drugs" 1 => "Steroids" 2 => "Hypoglycemia-inducing drugs" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec111939" "palabras" => array:3 [ 0 => "Antiinflamatorios no esteroideos" 1 => "Esteroides" 2 => "Hipoglucemiantes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To analyze the safety of combining non-steroidal anti-inflammatory drugs (NSAID) and hypoglycemia-inducing drugs.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A systematic review following a sensitive search strategy was performed. All articles published in MEDLINE (since 1961), EMBASE (since 1961), and Cochrane Library, up to December 2007, were examined. Selection criteria: the population (subjects taking hypoglycemia-inducing drugs: insulin or oral antidiabetic drugs [OAD]), the intervention (concomitantly use of NSAID), and the outcomes related to safety (gastrointestinal, renal, cardiovascular toxicity) and glycemic control. Titles and abstracts of retrieved articles meeting inclusion criteria from the search were reviewed. Only randomized controlled trials (RCT), or cohort studies were included.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 33 studies were reviewed in detail, and 11 were finally included, 10 low quality RCT, and 1 prospective cohort study with moderate quality, which included 199 patients. All patients were diabetics; mostly young or middle aged men, on different NSAID and hypoglycemic drugs. There was no evidence of important changes in patient's glycemic controls, nor in their renal function, when combining NSAID with hypoglycemia-inducing drugs. Moreover, there is no clear increase in the number of serious side effects.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">According to the published evidence, there are not enough arguments to contraindicate the use of NSAID with hypoglycemia-inducing drugs (insulin or OAD).</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar la seguridad del uso concomitante de antiinflamatorios no esteroideos (AINE) y fármacos hipoglucemiantes que permita la toma de decisiones en este sentido en la práctica diaria.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Revisión sistemática. Se definió una estrategia de búsqueda bibliográfica sensible en MEDLINE (desde 1961), EMBASE (desde 1980) y Cochrane Library hasta diciembre de 2007, definiendo la población (sujetos en tratamiento con fármacos hipoglucemiantes, tanto insulina como antidiabéticos orales [ADO]), la intervención (tratamiento concomitante con AINE) y los resultados (variables relacionadas con la seguridad–toxicidad gastrointestinal, renal o cardiovascular– y con el control glucémico). Se seleccionaron ensayos clínicos (EC) y estudios de cohortes de calidad.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se encontraron 33 estudios para analizar en detalle, de los cuales finalmente se incluyeron 11 en los análisis, de los que 10 fueron EC, en general de baja calidad, y 1 estudio de cohortes prospectivas de calidad moderada, que en total incluyeron a 199 pacientes. Todos los pacientes eran diabéticos, la mayoría varones jóvenes o de mediana edad en tratamiento con diferentes AINE y fármacos hipoglucemiantes. El uso de AINE con fármacos hipoglucemiantes no parece estar claramente asociado a cambios importantes en el control glucémico de estos pacientes ni se ha visto que altere significativamente su función renal. Tampoco se ha constatado que esta asociación aumente el número de eventos adversos graves.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Por la evidencia obtenida, no encontramos argumentos suficientes que claramente contraindiquen, debido a efectos secundarios, el uso concomitante de AINE e hipoglucemiantes (tanto ADO como insulina).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Advances in the adverse effects of NSAIDs in the gastrointestinal tract" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. 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| 2017 August | 17 | 7 | 24 |
| 2017 July | 15 | 8 | 23 |
| 2017 June | 35 | 10 | 45 |
| 2017 May | 24 | 10 | 34 |
| 2017 April | 20 | 10 | 30 |
| 2017 March | 22 | 18 | 40 |
| 2017 February | 12 | 2 | 14 |
| 2017 January | 18 | 4 | 22 |
| 2016 December | 65 | 10 | 75 |
| 2016 November | 32 | 4 | 36 |
| 2016 October | 61 | 6 | 67 |
| 2016 September | 47 | 1 | 48 |
| 2016 August | 36 | 8 | 44 |
| 2016 July | 26 | 5 | 31 |
| 2016 April | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 1 | 0 | 1 |
| 2015 July | 15 | 5 | 20 |
| 2015 June | 18 | 11 | 29 |
| 2015 May | 22 | 19 | 41 |
| 2015 April | 25 | 22 | 47 |
| 2015 March | 10 | 12 | 22 |
| 2015 February | 16 | 9 | 25 |
| 2015 January | 8 | 16 | 24 |
| 2014 December | 18 | 15 | 33 |
| 2014 November | 12 | 18 | 30 |
| 2014 October | 11 | 20 | 31 |
| 2014 September | 14 | 17 | 31 |
| 2014 August | 16 | 18 | 34 |
| 2014 July | 15 | 20 | 35 |
| 2014 June | 37 | 12 | 49 |
| 2014 May | 28 | 15 | 43 |
| 2014 April | 25 | 14 | 39 |
| 2014 March | 32 | 24 | 56 |
| 2014 February | 26 | 13 | 39 |
| 2014 January | 24 | 11 | 35 |
| 2013 December | 22 | 25 | 47 |
| 2013 November | 19 | 7 | 26 |
| 2013 October | 30 | 14 | 44 |
| 2013 September | 29 | 13 | 42 |
| 2013 August | 19 | 9 | 28 |
| 2013 July | 15 | 10 | 25 |
| 2013 June | 26 | 7 | 33 |
| 2013 May | 20 | 10 | 30 |
| 2013 April | 31 | 10 | 41 |
| 2013 March | 27 | 8 | 35 |
| 2013 February | 16 | 6 | 22 |
| 2013 January | 20 | 7 | 27 |
| 2012 December | 20 | 7 | 27 |
| 2012 November | 17 | 12 | 29 |
| 2012 October | 6 | 7 | 13 |
| 2012 September | 8 | 5 | 13 |
| 2012 July | 1 | 0 | 1 |
| 2012 June | 1 | 0 | 1 |
| 2012 May | 3 | 0 | 3 |
| 2012 April | 5 | 0 | 5 |
| 2012 March | 14 | 0 | 14 |
| 2012 February | 3 | 0 | 3 |
| 2012 January | 5 | 0 | 5 |
| 2011 December | 3 | 0 | 3 |
| 2011 November | 8 | 0 | 8 |
| 2011 October | 4 | 0 | 4 |
| 2011 September | 1 | 0 | 1 |
| 2011 August | 1 | 0 | 1 |
| 2011 June | 6 | 0 | 6 |
| 2011 May | 4 | 0 | 4 |
| 2011 March | 5 | 0 | 5 |
| 2011 February | 4 | 0 | 4 |
| 2011 January | 2 | 0 | 2 |
| 2010 December | 6 | 0 | 6 |
| 2010 November | 2 | 0 | 2 |
| 2010 October | 8 | 0 | 8 |
| 2010 September | 4 | 0 | 4 |
| 2010 August | 3 | 0 | 3 |
| 2010 July | 3 | 0 | 3 |
| 2010 June | 2 | 0 | 2 |
| 2010 May | 5 | 0 | 5 |
| 2010 April | 6 | 0 | 6 |
| 2010 March | 5 | 0 | 5 |
| 2010 February | 3 | 0 | 3 |
| 2010 January | 3 | 0 | 3 |
| 2009 December | 11 | 0 | 11 |
| 2009 November | 7 | 0 | 7 |
| 2009 October | 13 | 0 | 13 |
| 2009 September | 10 | 0 | 10 |
| 2009 August | 5 | 0 | 5 |
| 2009 July | 3 | 0 | 3 |
| 2009 June | 10 | 0 | 10 |
| 2009 May | 15 | 0 | 15 |
| 2009 April | 27 | 0 | 27 |
| 2009 March | 10 | 0 | 10 |
Show all
