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Safety of etoricoxib, celecoxib and non-selective NSAIDs in Ankylosing spondylitis and other Spondyloarthritis patients: A Swedish national population based cohort study.

Kristensen, Lars Erik LU ; Jakobsen, A K; Askling, J; Nielsson, F X and Jacobsson, L T H (2015) In Arthritis Care and Research1988-01-01+01:002000-01-01+01:00 67(8). p.1137-1149
Abstract
Objective: Safety data regarding the usage of etoricoxib and other nonsteroidal anti-inflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. To estimate and compare rates of gastrointestinal, renovascular, and cardiovascular adverse events in patients exposed to etoricoxib, celecoxib, non-selective NSAIDs (nsNSAIDs) or totally unexposed to NSAIDs. Methods: This is a national register-based cohort study on patients with AS or SpA (N=21,872) identified in the Swedish national patient register (NPR) 1987 - 2009. Treatment exposure was assessed time-dependently based on the prescription drugs register from 2006 - 2009 adjusting for socio-demography, and comorbidities derived... (More)
Objective: Safety data regarding the usage of etoricoxib and other nonsteroidal anti-inflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. To estimate and compare rates of gastrointestinal, renovascular, and cardiovascular adverse events in patients exposed to etoricoxib, celecoxib, non-selective NSAIDs (nsNSAIDs) or totally unexposed to NSAIDs. Methods: This is a national register-based cohort study on patients with AS or SpA (N=21,872) identified in the Swedish national patient register (NPR) 1987 - 2009. Treatment exposure was assessed time-dependently based on the prescription drugs register from 2006 - 2009 adjusting for socio-demography, and comorbidities derived from national population-based registers. Results: Exposure to etoricoxib, celecoxib and nsNSAID were 7.6%, 3.9% and 71.2%, respectively. No major risk differences for serious cardiovascular, gastrointestinal or renal adverse events were seen among the three exposure groups. Patients unexposed to NSAIDs had more baseline co-morbidities and an increased relative risk for congestive heart failure events during the study period 2.0 (95% 1.3 to 3.2). The relative risk for atherosclerotic events was non-significant when compared to the nsNSAID group 1.0 (95% CI: 0.7 to 1.5), while the risk for gastrointestinal events was lower for unexposed patients 0.5 (0.4 to 0.7). Conclusion: Overall, serious adverse events related to nsNSAID, etoricoxib and celecoxib were similar and in the range of what would be expected in a group of SpA patients. Patients unexposed to NSAIDs had considerable more baseline co-morbidities and increased risk for congestive heart failure, reflecting a selection of patients being prescribed NSAID in clinical practice. This article is protected by copyright. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis Care and Research1988-01-01+01:002000-01-01+01:00
volume
67
issue
8
pages
1137 - 1149
publisher
John Wiley & Sons
external identifiers
  • pmid:25623277
  • wos:000358617000013
  • scopus:84937902866
ISSN
2151-4658
DOI
10.1002/acr.22555
language
English
LU publication?
yes
id
51b4d69c-81ab-422c-bd06-ca4a5c82edc4 (old id 5039658)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25623277?dopt=Abstract
date added to LUP
2015-02-04 17:51:46
date last changed
2017-09-10 03:28:48
@article{51b4d69c-81ab-422c-bd06-ca4a5c82edc4,
  abstract     = {Objective: Safety data regarding the usage of etoricoxib and other nonsteroidal anti-inflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. To estimate and compare rates of gastrointestinal, renovascular, and cardiovascular adverse events in patients exposed to etoricoxib, celecoxib, non-selective NSAIDs (nsNSAIDs) or totally unexposed to NSAIDs. Methods: This is a national register-based cohort study on patients with AS or SpA (N=21,872) identified in the Swedish national patient register (NPR) 1987 - 2009. Treatment exposure was assessed time-dependently based on the prescription drugs register from 2006 - 2009 adjusting for socio-demography, and comorbidities derived from national population-based registers. Results: Exposure to etoricoxib, celecoxib and nsNSAID were 7.6%, 3.9% and 71.2%, respectively. No major risk differences for serious cardiovascular, gastrointestinal or renal adverse events were seen among the three exposure groups. Patients unexposed to NSAIDs had more baseline co-morbidities and an increased relative risk for congestive heart failure events during the study period 2.0 (95% 1.3 to 3.2). The relative risk for atherosclerotic events was non-significant when compared to the nsNSAID group 1.0 (95% CI: 0.7 to 1.5), while the risk for gastrointestinal events was lower for unexposed patients 0.5 (0.4 to 0.7). Conclusion: Overall, serious adverse events related to nsNSAID, etoricoxib and celecoxib were similar and in the range of what would be expected in a group of SpA patients. Patients unexposed to NSAIDs had considerable more baseline co-morbidities and increased risk for congestive heart failure, reflecting a selection of patients being prescribed NSAID in clinical practice. This article is protected by copyright. All rights reserved.},
  author       = {Kristensen, Lars Erik and Jakobsen, A K and Askling, J and Nielsson, F X and Jacobsson, L T H},
  issn         = {2151-4658},
  language     = {eng},
  number       = {8},
  pages        = {1137--1149},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis Care and Research1988-01-01+01:002000-01-01+01:00},
  title        = {Safety of etoricoxib, celecoxib and non-selective NSAIDs in Ankylosing spondylitis and other Spondyloarthritis patients: A Swedish national population based cohort study.},
  url          = {http://dx.doi.org/10.1002/acr.22555},
  volume       = {67},
  year         = {2015},
}