罗非昔布在骨关节炎、急性疼痛和类风湿性关节炎治疗中的应用综述。

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Matheson AJ, Figgitt DP

罗非昔布在骨关节炎、急性疼痛和类风湿性关节炎治疗中的应用综述。

药。2001;61(6):833 - 65。

PubMed ID

11398914 (PubMed视图

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摘要

Rofecoxib是一种选择性环加氧酶(COX)-2抑制剂，在剂量高达1000mg /天时，对COX-1同工酶几乎没有影响。罗非昔布对COX-2的选择性高于塞来昔布、美洛昔康、双氯芬酸和吲哚美辛。在良好对照的临床试验中，rofecoxib 12.5 ~ 500 mg/day已被评估其治疗骨关节炎、急性疼痛和类风湿性关节炎的疗效[低剂量(5 ~ 125 mg/day)通常用于慢性疼痛适应症]。在骨关节炎患者的治疗中，罗非昔布比安慰剂、扑热息痛(对乙酰氨基酚)和塞来昔布更有效地缓解症状，与布洛芬、双氯芬酸、萘普生和纳布美酮的疗效相似。总的来说，医生对疾病状况的评估和患者对治疗反应的评估都倾向于罗非昔布。在术后牙痛、脊柱融合术或骨科手术后疼痛或原发性痛经患者中，罗非昔布比安慰剂提供了更快速和更持久的疼痛缓解，并减少了术后补充吗啡的使用需求。罗非昔布在急性牙痛和脊柱融合术后疼痛患者中比塞来昔布更有效，尽管塞来昔布可能已被用于亚治疗剂量。与传统的非甾体抗炎药布洛芬、双氯芬酸和萘普生钠相比，罗非昔布治疗急性疼痛的疗效相似。虽然在原发性痛经患者中，萘普生钠比罗非昔布能更快速地缓解疼痛，但在骨科手术后，情况正好相反:罗非昔布能更快速地缓解疼痛，需要补充的吗啡更少。Rofecoxib与萘普生一样有效地缓解了超过8700例类风湿性关节炎患者的症状。 Compared with traditional NSAID therapy, rofecoxib had a significantly lower incidence of endoscopically confirmed gastroduodenal ulceration and, in approximately 13,000 patients with osteoarthritis and rheumatoid arthritis, a lower incidence of gastrointestinal (GI) adverse events. Rofecoxib was generally well tolerated in all indications with an overall tolerability profile similar to traditional NSAIDs. The most common adverse events in rofecoxib recipients were nausea, dizziness and headache. In conclusion, rofecoxib is at least as effective as traditional NSAID therapy in providing pain relief for both chronic and acute pain conditions. Rofecoxib provides an alternative treatment option to traditional NSAID therapy in the management of symptomatic pain relief in patients with osteoarthritis. Initial data from patients with primary dysmenorrhoea and postoperative pain are promising and further trials may confirm its place in the treatment of these indications. Rofecoxib has also shown promising results in patients with rheumatoid arthritis and is likely to become a valuable addition to current drug therapy for this patient population. Importantly, rofecoxib is associated with a lower incidence of GI adverse events than traditional NSAIDs making it a primary treatment option in patients at risk of developing GI complications or patients with chronic conditions requiring long term treatment.

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药物	目标	种类	生物	药理作用	行动
万	前列腺素G/H合成酶2	蛋白质	人类	是的	抑制剂	细节