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

Gerd Burmester, Angel Lanas, Luigi Biasucci, Matthias Hermann, Stefan Lohmander, Ignazio Olivieri, Carmelo Scarpignato, Josef Smolen, Chris Hawkey and Adam Bajkowski, et al. (2011) 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 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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
INHIBITORS, GUIDELINES, EFFICACY, THERAPY, GASTROINTESTINAL SAFETY, TRIALS
journal title
ANNALS OF THE RHEUMATIC DISEASES
Ann. Rheum. Dis.
volume
70
issue
5
pages
818 - 822
Web of Science type
Article
Web of Science id
000289070500018
JCR category
RHEUMATOLOGY
JCR impact factor
8.727 (2011)
JCR rank
1/29 (2011)
JCR quartile
1 (2011)
ISSN
0003-4967
DOI
10.1136/ard.2010.128660
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1842961
handle
http://hdl.handle.net/1854/LU-1842961
date created
2011-06-28 10:13:17
date last changed
2012-01-24 12:24:15
@article{1842961,
  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         = {0003-4967},
  journal      = {ANNALS OF THE RHEUMATIC DISEASES},
  keyword      = {INHIBITORS,GUIDELINES,EFFICACY,THERAPY,GASTROINTESTINAL SAFETY,TRIALS},
  language     = {eng},
  number       = {5},
  pages        = {818--822},
  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},
}

Chicago
Burmester, Gerd, Angel Lanas, Luigi Biasucci, Matthias Hermann, Stefan Lohmander, Ignazio Olivieri, Carmelo Scarpignato, et al. 2011. “The Appropriate Use of Non-steroidal Anti-inflammatory Drugs in Rheumatic Disease: Opinions of a Multidisciplinary European Expert Panel.” Annals of the Rheumatic Diseases 70 (5): 818–822.
APA
Burmester, G., Lanas, A., Biasucci, L., Hermann, M., Lohmander, S., Olivieri, I., Scarpignato, C., et al. (2011). The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. ANNALS OF THE RHEUMATIC DISEASES, 70(5), 818–822.
Vancouver
1.
Burmester G, Lanas A, Biasucci L, Hermann M, Lohmander S, Olivieri I, et al. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. ANNALS OF THE RHEUMATIC DISEASES. 2011;70(5):818–22.
MLA
Burmester, Gerd, Angel Lanas, Luigi Biasucci, et al. “The Appropriate Use of Non-steroidal Anti-inflammatory Drugs in Rheumatic Disease: Opinions of a Multidisciplinary European Expert Panel.” ANNALS OF THE RHEUMATIC DISEASES 70.5 (2011): 818–822. Print.