В обзоре литературы представлены возможности использования нестероидных противовоспалительных препаратов (НПВП) при полиморбидной патологии. Рассмотрены механизм действия НПВП, факторы риска развития нежелательных эффектов на сердечно-сосудистую, пищеварительную, мочевыделительную и другие системы; обсуждаются меры профилактики и возможности выбора препарата, рассматривается алгоритм назначения НПВП.
Ключевые слова: нестероидные противовоспалительные препараты, полиморбидность, показания к назначению НПВП, противопоказания к назначению НПВП.
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The literature review presents the possibilities of using non-steroidal anti-inflammatory drugs (NSAIDs) for polymorbid pathology. The mechanism of NSAIDs action, risk factors for the development of undesirable effects on the cardiovascular, digestive, urinary and other systems are considered; prevention measures and drug selection options are discussed, NSAIDs prescribing algorithm is considered.
Keywords: nonsteroidal anti-inflammatory drugs, polymorbidity, indications for NSAIDs, contraindications for NSAIDs.
Список литературы
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1. Shirinsky VS, Shirinsky IV. Comorbid diseases as an important problem of clinical medicine. Sibirskii meditsinskii zhurnal. 2014;29(1):7-12 (In Russ.) doi: 10.29001/2073-8552-2014-29-1-7-12
2. Karateev AE, Nasonov EL, Yakhno NN, Ivashkin VT, Chichasova NV, Alekseeva LI, et al. Clinical guidelines «Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice». Sovremennaya revmatologiya. 2015;(1):4-23 (In Russ.) doi: 10.14412/1996-7012-2015-1-4-23
3. Theodoridou A, Gika H, Diza E, Garyfallos A, Settas L. In vivo study of pro-inflammatory cytokine changes in serum and synovial fluid during treatment with celecoxib and etoricoxib and correlation with VAS pain change and synovial membrane penetration index in patients with inflammatory arthritis. Mediterranian J Rheumatol. 2017;28(1):43-50. doi: 10.31138/mjr.28.1.43
4. Metzner J, Popp L, Marian C, Schmidt R, Manderscheid C, Renne C, et al. The effects of COX-2 selective and non-selective NSAIDs on the initiation and progression of atherosclerosis in ApoE-/- mice. J Molecular Medicine (Berlin). 2007;85(6):623-33. doi: 10.1007/s00109-007-0162-9
5. Schmidt M, Lamberts M, Olsen A-MS, Fosbøll E, Niessner A, Tamargo J, et al. Cardiovascular safety of non-aspirin non-steroidal anti-inflammatory drugs: review and position paper by the working group for Cardiovascular Pharmacotherapy of the European Society of Cardiology. Eur Heart J. 2016;37(13):1015-23. doi:10.1093/eurheartj/ehv505
6. Varga Z, Sabzwari S, Vargova V. Cardiovascular Risk of Nonsteroidal Anti-Inflammatory Drugs: An Under-Recognized Public Health Issue Cureus. 2017 Apr; 9(4):e1144. Published online 2017 Apr 8. doi: 10.7759/cureus.1144 PMCID: PMC5422108
7. Morozova TE, Shmarova DG, Rykova SM. The choice of non-steroidal anti-inflammatory drugs in patients with rheumatologic profile with concomitant cardiovascular diseases. Lechashii vrach. 2016;(7):39-45 (In Russ.)
8. Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382:769-79. doi:10.1016/S0140-6736(13)60900-9
9. Zotova LA, Petrov VS. Nonsteroidal anti-inflammatory drugs in modern clinical practice: focus on safety. Nauka molodych. 2015;(1):25-30 (In Russ.)
10. Nasonov EL. Primenenie nesteroidnyh protivovospalitelnyh preparatov I ingibitorov ciklooxigenasy-2 v nachale XXI veka. Russkii Meditsinskii zhurnal. 2003;11(7):375-8 (In Russ.)
11. Chichasova NV, Imametdinova GR, Igolkina EV, Nasonov EL. Naiz v lechenii hronicheskih zabolevanii sustavov. Russkii Meditsinskii zhurnal. 2012;(17) (In Russ.) https://medi.ru/info/11713/
12. Patompong Ungprasert, Wonngarm Kittanamongkolchai, Chrystal Price, Supawat Ratanapo, Napat Leeaphorn, Daych Chongnarungsin, Wisit Cheungpasitporn. What Is The “Safest” Non-Steroidal Anti-Inflammatory Drugs? Am Medical J. 2012;3(2):115-23. doi: 10.3844/ amjsp.2012.115
13. Karateev AE, Novikova DS, Nasonov EL. New data on the safety of nonsteroidal anti-inflamatory drugs: the concept of the high class-specific cardiovascular risk of selective cyclooxygenase-2 inhibitors is outdated. Rheumatology Science and Practice. 2017;55(2):218-23 (In Russ.) doi: 10.14412/1995-4484-2017-218-223
14. Gislason GH, Rasmussen JN, Abildstrom SZ, Schramm TK, Hansen ML, Fosbol EL, et al. Increased mortality and cardiovascular morbidity associated with use of nonsteroidal anti-inflammatory drugs in chronic heart failure. Archive Internal Medicine. 2009;169(2):141-9. doi: 10.1001/archinternmed.2008.525
15. Martín Arias LH, Martín González A, Sanz Fadrique R, Vazquez ES. Cardiovascular Risk of Nonsteroidal Anti-inflammatory Drugs and Classical and Selective Cyclooxygenase-2 Inhibitors: A Meta-analysis of Observational Studies. J Clin Pharmacol. 2019;59(1):55-73. doi: 10.1002/jcph.1302
16. Arfè A, Scotti L, Varas-Lorenzo C, Nicotra F, Zambon A, Kollhorst B, et al. Safety of Non-steroidal Anti-inflammatory Drugs (SOS) Project Consortium.Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study. British Medical J. 2016;354(28):i4857. doi: 10.1136/bmj.i4857
17. Nissen SE, Yeomans ND, Solomon DH, Lüscher TF, Libby P, Husni ME, et al. PRECISION Trial Investigators. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. New England J Medicine. 2016;375(26):2519-29. doi: 10.1056/NEJMoa1611593
18. Slomski A. Celecoxib Similar to 2 NSAIDs for Cardiovascular Safety. J Amer Medical Association. 2016;316(24):2589. doi: 10.1001/ jama.2016.19355
19. Ruschitzka F, Borer JS, Krum H, Flammer AJ, Yeomans ND, Libby P, et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. Eur Heart J. 2017;38(44):3282-92. doi: 10.1093/eurheartj/ehx508
20. White WB, Kloner RA, Angiolillo DJ, Davidson MH. Cardiorenal Safety of OTC Analgesics. J Cardiovasc Pharm Ther. 2018;23(2):103-18. doi: 10.1177/1074248417751070
21. Reed GW, Riaz H, Wang Q, Wolski K, Wisniewski L, Menon V, et al. Comparison of the safety of celecoxib, ibuprofen, andnaproxen in patients without established cardiovascular diseases. J Amer College of Cardiol. 2019;73(9)(suppl 1). doi: 10.1016/S0735-1097(19)30637-0
22. Balabanova RM. Cardiovascular effects of selective COX-2 inhibitorsin rheumatic diseases. Modern Rheumatol J. 2010;4(2):88-93 (In Russ.) doi: 10.14412/1996-7012-2010-609
23. Naumov AV, Tkacheva ON, Khovasova NO. Safety of nonsteroidal anti-inflammatory drugs in patients with cardiovascular risk. Therapeutic Archive. 2019;91(1):108-13 (In Russ.) doi: 10.26442/ 00403660.2019.01.000039
24. Ligina EV. The effectiveness and safety of the use of nimulidus for people who have osteoarthritis with hypertonia. Rossiiskii medico-biologicheskii vestnik imini akademika IP Pavlova. 2006;(1):44-50 (In Russ.)
25. Ejaz P, Bhojani K, Joshi VR. NSAIDs and Kidney. JAPI. 2004;52: 632-40. www.japi.org
26. Dixit M, Doan T, Kirschner R, Dixit N. Significant Acute Kidney Injury Due to Non-steroidal Anti-inflammatory Drugs: Inpatient Setting. Pharmaceuticals (Basel). 2010;3(4):1279-85. doi: 10.3390/ph3041279
27. Park KE, Qin Y, Bavry AA. Nonsteroidal anti-inflammatory drugs and their effects in the elderly. Aging Health. 2012;8(2):167-77.
28. Leo RJ. Safe Analgesic Use in Patients with Renal Dysfunction. General guidelines for appropriate use of analgesics and co-analgesic adjuvants in pain patients with co-existing renal insufficiency. Practical Pain Management. 2014;8(5). https://www.practicalpainmanagement.com/treatments/pharmacologi cal/safe-analgesic-use-patients-renal-dysfunction?page=0,3
29. Chih-Cheng Hsu, Hongjian Wang, Yueh-Han Hsu, Shao-Yuan Chuang, Ya-Wen Huang, Yu-Kang Chang, et al. Use of Nonsteroidal Anti-Inflammatory Drugs and Risk of Chronic Kidney Disease in Subjects With Hypertension. Nationwide Longitudinal Cohort Study. Hypertension. 2015;66:524-33. doi:/10.1161/HYPERTENSIONAHA.114.05105
30. Voronina NV, Gelmutdinov DD, Markina OI. Iifluence of non-steroid anti-inflammatory drugs COX inhibitors and non-COX inhibitors on the condition of kidneys of patients suffering from oxalate nephropathy associated with osteoarthrosis. Dal’nevostochnyi meditsinskii zhurnal. 2016;1:14-9 (In Russ.)
31. Nelson DA, Marks ES, Deuster PA, O’Connor FG, Kurina LM. Association of Nonsteroidal Anti-inflammatory Drug Prescriptions With Kidney Disease Among Active Young and Middle-aged Adults. J Amer Medical Association Netw Open. 2019;2(2):e187896. Published online February 15. doi: 10.1001/jamanetworkopen.2018.7896
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Авторы
Н.С. Асфандиярова, Е.В. Филиппов
ФГБОУ ВО «Рязанский государственный медицинский университет им. академика И.П. Павлова» Минздрава России, Рязань, Россия