塞来昔布对零星的结直肠腺瘤的预防。

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Bertagnolli MM,鹰CJ, Zauber AG) Redston M,所罗门SD,金正日K,唐J, Rosenstein RB, Wittes J, Corle D,赫斯TM, Woloj通用,Boisserie F,安德森WF Viner杰,阿訇D,燃烧J,钟,杜瓦T, Foley TR,霍夫曼N,麦克雷F,普瑞特再保险、小萨尔兹曼,扎尔茨贝格B, Sylwestrowicz T,戈登GB,鹰等

塞来昔布对零星的结直肠腺瘤的预防。

郑传经地中海J。2006年8月31日,355 (9):873 - 84。

PubMed ID

16943400 (在PubMed

]

文摘

背景:研究表明,药物抑制cyclooxygenase-2 (cox - 2)减少结直肠腺瘤的动物和家族性腺瘤息肉病表明cox - 2抑制剂的患者也可能防止零星的结直肠肿瘤。方法:我们随机分配患者腺瘤切除前研究进入接受安慰剂(679例)或200毫克(685例)或400毫克每天两次(671名患者)的塞来昔布。随机分层使用低剂量的阿司匹林。后续结肠镜进行随机化后在一到三年。最新发现的结直肠腺瘤的发生比较各组之间的生命表扩展Mantel-Haenszel测试。结果:随访结肠镜检查完成后在89.5%的随机化患者的第一年,在3 75.7%。估计累积的检测一个或多个腺瘤发病率由三年级接受安慰剂的患者为60.7%,与43.2%相比那些接受200毫克的塞来昔布一天两次(风险比,0.67;95%置信区间,0.59 - 0.77;P < 0.001), 37.5%的接受400毫克的塞来昔布一天两次(风险比,0.55;95%置信区间,0.48 - 0.64; P<0.001). Serious adverse events occurred in 18.8 percent of patients in the placebo group, as compared with 20.4 percent of those in the low-dose celecoxib group (risk ratio, 1.1; 95 percent confidence interval, 0.9 to 1.3; P=0.5) and 23.0 percent of those in the high-dose group (risk ratio, 1.2; 95 percent confidence interval, 1.0 to 1.5; P=0.06). As compared with placebo, celecoxib was associated with an increased risk of cardiovascular events (risk ratio for the low dose, 2.6; 95 percent confidence interval, 1.1 to 6.1; and risk ratio for the high dose, 3.4; 95 percent confidence interval, 1.5 to 7.9). CONCLUSIONS: These findings indicate that celecoxib is an effective agent for the prevention of colorectal adenomas but, because of potential cardiovascular events, cannot be routinely recommended for this indication. (ClinicalTrials.gov number, NCT00005094 [ClinicalTrials.gov].).

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药物

塞来昔布