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The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel

Burmester, Gerd; Lanas, Angel; Biasucci, Luigi; Hermann, Matthias; Lohmander, Stefan LU ; Olivieri, Ignazio; Scarpignato, Carmelo; Smolen, Josef; Hawkey, Chris and Bajkowski, Adam, et al. (2011) In Annals of the Rheumatic Diseases 70(5). p.818-822
Abstract
Introduction Given the safety issues of nonsteroidal anti-inflammatory drugs (NSAID) and the robustness of guidelines, making treatment choices in daily clinical practice is increasingly difficult. This study aimed systematically to analyse the opinions of a multidisciplinary European expert panel on the appropriateness of different NSAID, with or without the use of a proton pump inhibitor (PPI), in individual patients with chronic rheumatic disease. Methods Using the Research and Development/University of California at Los Angeles appropriateness method, the appropriateness of five (non-)selective NSAID with or without a PPI was assessed for 144 hypothetical patient profiles, ie, unique combinations of cardiovascular and gastrointestinal... (More)
Introduction Given the safety issues of nonsteroidal anti-inflammatory drugs (NSAID) and the robustness of guidelines, making treatment choices in daily clinical practice is increasingly difficult. This study aimed systematically to analyse the opinions of a multidisciplinary European expert panel on the appropriateness of different NSAID, with or without the use of a proton pump inhibitor (PPI), in individual patients with chronic rheumatic disease. Methods Using the Research and Development/University of California at Los Angeles appropriateness method, the appropriateness of five (non-)selective NSAID with or without a PPI was assessed for 144 hypothetical patient profiles, ie, unique combinations of cardiovascular and gastrointestinal risk factors. Appropriateness statements were calculated for all indications. Results All options without PPI were considered appropriate in patients with no gastrointestinal/cardiovascular risk factors. Cyclooxygenase-2 selective inhibitors (C2SI) alone and non-selective NSAID plus PPI were preferred for patients with elevated gastrointestinal risk and low cardiovascular risk. Naproxen plus PPI was favoured in patients with high cardiovascular risk. For the combination of high gastrointestinal/high cardiovascular risk the use of any NSAID was discouraged; if needed, naproxen plus PPI or a C2SI plus PPI could be considered. Discussion The panel results may support treatment considerations at the level of individual patients, according to their gastrointestinal/cardiovascular risk profile. (Less)
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published
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in
Annals of the Rheumatic Diseases
volume
70
issue
5
pages
818 - 822
publisher
British Medical Association
external identifiers
  • wos:000289070500018
  • scopus:79953320827
ISSN
1468-2060
DOI
10.1136/ard.2010.128660
language
English
LU publication?
yes
id
7a9048b6-45d3-4a8f-8275-497ef86aa7b5 (old id 1918651)
date added to LUP
2011-05-02 10:59:10
date last changed
2017-07-02 04:04:05
@article{7a9048b6-45d3-4a8f-8275-497ef86aa7b5,
  abstract     = {Introduction Given the safety issues of nonsteroidal anti-inflammatory drugs (NSAID) and the robustness of guidelines, making treatment choices in daily clinical practice is increasingly difficult. This study aimed systematically to analyse the opinions of a multidisciplinary European expert panel on the appropriateness of different NSAID, with or without the use of a proton pump inhibitor (PPI), in individual patients with chronic rheumatic disease. Methods Using the Research and Development/University of California at Los Angeles appropriateness method, the appropriateness of five (non-)selective NSAID with or without a PPI was assessed for 144 hypothetical patient profiles, ie, unique combinations of cardiovascular and gastrointestinal risk factors. Appropriateness statements were calculated for all indications. Results All options without PPI were considered appropriate in patients with no gastrointestinal/cardiovascular risk factors. Cyclooxygenase-2 selective inhibitors (C2SI) alone and non-selective NSAID plus PPI were preferred for patients with elevated gastrointestinal risk and low cardiovascular risk. Naproxen plus PPI was favoured in patients with high cardiovascular risk. For the combination of high gastrointestinal/high cardiovascular risk the use of any NSAID was discouraged; if needed, naproxen plus PPI or a C2SI plus PPI could be considered. Discussion The panel results may support treatment considerations at the level of individual patients, according to their gastrointestinal/cardiovascular risk profile.},
  author       = {Burmester, Gerd and Lanas, Angel and Biasucci, Luigi and Hermann, Matthias and Lohmander, Stefan and Olivieri, Ignazio and Scarpignato, Carmelo and Smolen, Josef and Hawkey, Chris and Bajkowski, Adam and Berenbaum, Francis and Breedveld, Ferdinand and Dieleman, Peter and Dougados, Maxime and MacDonald, Thomas and Martin Mola, Emilio and Mets, Tony and Van den Noortgate, Nele and Stoevelaar, Herman},
  issn         = {1468-2060},
  language     = {eng},
  number       = {5},
  pages        = {818--822},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel},
  url          = {http://dx.doi.org/10.1136/ard.2010.128660},
  volume       = {70},
  year         = {2011},
}