[How to watch over a patient treated with a NSAID in relation to the cardiovascular and renal risk?].
Despite the cardiovascular risk attributable to the NSAIDs, these drugs are among the most prescribed treatments in the world. Recently to manage this risk during chronic inflammatory rheumatisms a surveillance plan has been developed based on a decision algorithm. Given that the arterial thrombotic risks (myocardial or cerebral) are observed essentially during long-term treatments, two types of situation have been envisaged, short-term treatments and long-term treatments. Before any short-term NSAID prescription (less than one month), the cardio-renal risk should be evaluated. A pre-therapeutic check-up should include the search for risk factors and the treatment surveillance should imply a clinical and biological check-up carried out after 2 to 3 weeks of treatment. Before any long-term NSAID prescription (more than one month), the arterial thrombotic risk (cardiac or cerebral) should be evaluated and the patient's history determined. Pre-therapeutic check-up and surveillance should be carried out and reconsidered at least every three months. In the case of high risk, the advice of a cardiologist should be obtained and drastic therapeutic measures taken. There are cases where the prescription of NSAIDs or coxibs is possibly not recommended.
Schaeverbeke
Thierry
T
Service de Rhumatologie, CHU Pellegrin, Bordeaux.
Héloire
François
F
Deray
Gilbert
G
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000517:prevention & control; D011307:Drug Prescriptions; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control; D010808:Physical Examination; D012307:Risk Factors; D013927:Thrombosis / Q000139:chemically induced / Q000517:prevention & control
D000894:Anti-Inflammatory Agents, Non-Steroidal