title: [Gastrointestinal side effects of non-steroidal anti-inflammatory drugs in high-risk patients--role of selective cyclooxygenase inhibitors].
abstract: Non-steroidal anti-inflammatory drugs (NSAID) are the most widely used drugs in the world. Gastrointestinal (GI) side effects of NSAID have a significant economical impact (3-4% clinical GI event, and 1.5% serious/life threatening GI event/year). Selective cyclooxigenase-2 inhibitors (coxibs) are equally effective as non-selective NSAID with about 50% reduction of serious/life threatening GI events. Serious GI events are significantly less in high-risk patients (history of peptic ulcer disease, age over 65 years, treatment with anticoagulants), therefore the use of coxibs is cost-effective in these population. Most of patients with long-term NSAID therapy also require co-therapy with acid suppression or prostaglandin analogue, but coxibs may replace both. The treatment with coxibs in long-term NSAID users thus is cheaper then non-selective NSAID + co-therapy. Patients with GI adverse events during coxib therapy require co-therapy with acid suppression or prostaglandin analogue.
authors.affiliation: Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest. pronai@bel2.sote.hu
authors.forename: L
authors.initials: L
authors.lastname: Prónai
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D004064:Digestive System / Q000187:drug effects*; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008565:Membrane Proteins; D010437:Peptic Ulcer / Q000139:chemically induced / Q000191:economics / Q000517:prevention & control*; D011451:Prostaglandin-Endoperoxide Synthases; D012306:Risk
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D001241:Aspirin
vernacular_title: A nem szteroid gyulladásgátlók emésztórendszeri mellékhatásai fokozott kockázatú betegekben--a specifikus ciklooxigenázgátlók szerepe.