Article information
Abstract
Objectives
To analyze the safety of combining non-steroidal anti-inflammatory drugs (NSAID) and steroids.
MethodsA 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 with musculoskeletal diseases on steroids), the intervention (concomitant use of NSAID), and outcomes related to drugs safety (gastrointestinal, renal, and cardiovascular toxicity). Titles and abstracts of retrieved articles meeting inclusion criteria from the search were reviewed. Only randomized controlled trials (RCT) or high quality cohort studies with a control group were included.
ResultsOf a total of 4164 references retrieved, 42 were analyzed in detail, and 10 were finally included, 6 RCT and 4 prospective cohort studies, which included more than 20 000 patients.
ConclusionsThe use of NSAID and low dose of steroids in patients with musculoskeletal diseases does not seem to increase the risk of gastrointestinal adverse events.
Key words:
Non-steroidal anti-inflammatory drugs
Steroids
Safety
Resumen
Objetivos
Analizar la seguridad del uso concomitante de antiinflamatorios no esteroideos (AINE) con esteroides en pacientes con enfermedad reumática.
MétodosRevisión sistemática. Se definió una estrategia de búsqueda bibliográfica sensible en MEDLINE (desde 1961), EMBASE (desde 1980) y Cochrane Library hasta diciembre del 2007, definiendo la población (sujetos con enfermedad reumática en tratamiento con esteroides) y la intervención (tratamiento concomitante con AINE) y definiendo como resultados variables de seguridad (toxicidad gastrointestinal, renal y cardiovascular). Se seleccionaron ensayos clínicos y estudios de cohortes de calidad.
ResultadosSe recuperaron 4.164 estudios, de los que 42 se analizaron en detalle; finalmente se incluyeron 10 en los análisis, 6 de los cuales fueron ensayos clínicos y 4, estudios de cohortes prospectivos, que incluyeron a más de 20.000 pacientes.
ConclusionesEl uso concomitante de AINE y esteroides a dosis bajas en pacientes con enfermedad reumática no parece que incremente el riesgo de eventos adversos gastrointestinales.
Palabras clave:
Antiinflamatorios no esteroideos
Esteroides
Seguridad
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