Comparative antiplatelet activity of COX1 NSAIDS versus aspirin, encompassing regimen simplification and gastroprotection: a call for a controlled study.
This study was conducted to assess the feasibility of COX1 NSAID substitution for aspirin for preventative therapy related to circulating anticoagulants, as manifest by inhibition of platelet aggregation. There was no difference in platelet aggregation inhibition between aspirin, naproxen, ketoprofen or diclofenac and misoprostol (in combination in the form of Arthrotec). As COX1 NSAIDs appear equivalent in platelet inhibition efficacy to aspirin, therapeutic regimens can be simplified in those individuals who require an NSAID for other problems. Further, despite its short serum halflife, Arthrotec appears as effective as an antiplatelet agent. Controlled, double blind studies of efficacy in blocking clinical events (both cardiovascular and gastrointestinal) are recommended.
Arthritis Center of Northeast Ohio and Northeastern Ohio Universities College of Medicine, 5500 Market Street, Youngstown, Ohio 44512, USA. bmr@neoucom.edu
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Rothschild
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009288:Naproxen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013270:Stomach / Q000187:drug effects; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; C078133:Arthrotec; D016861:Cyclooxygenase Inhibitors; D004338:Drug Combinations; D010975:Platelet Aggregation Inhibitors; D016595:Misoprostol; D004008:Diclofenac; D009288:Naproxen; D007660:Ketoprofen; D001241:Aspirin