Adverse Reactions of the Cardiovascular System when Taking Nonsteroidal Anti-inflammatory Drugs and Ways to Reduce Them

Пырикова, Н. В.; Антропова, О. Н.; Осипова, И. В.

doi:10.20996/1819-6446-2019-15-5-750-758

Racionalʹnaâ farmakoterapiâ v kardiologii

2019

DOI: 10.20996/1819-6446-2019-15-5-750-758

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Adverse Reactions of the Cardiovascular System when Taking Nonsteroidal Anti-inflammatory Drugs and Ways to Reduce Them

Н. В. Пырикова

О. Н. Антропова

И. В. Осипова

Abstract: The most important issue of modern pharmacotherapy is not only efficacy, but also the safety of medicines. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is one of the main methods of treating acute and chronic pain in a wide range of diseases and pathological conditions. However, the prescription of this group of drugs requires consideration of the potential risks of complications, including from the side of the cardiovascular system. The purpose of the review was to assess the adverse reactions of … Show more

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Cited by 5 publications

References 42 publications

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Results of a clinical study of Traumeel® S and Zeel® T in patients with knee osteoarthritis and concomitant cardiovascular disease

Alekseeva,

Mazurov,

Zonova

et al. 2023

Sovremennaâ revmatologiâ

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Objective: to evaluate the efficacy and safety of simultaneous intramuscular administration of Traumeel® S and Zeel® T followed by therapy with the tablet medication Zeel® T in patients with knee osteoarthritis (OA) and concomitant cardiovascular diseases. Material and methods. The analysis included 119 patients aged 45–79 years (78.2 % women and 21.8 % men) with confirmed diagnosis of knee OA according to Altman criteria, stage II–III according to Kellgren–Lawrence and confirmed cardiovascular disease. The main indicator of efficacy was the change in pain intensity in the target knee joint according to the “Pain” subscale of the WOMAC questionnaire (A) at the final examination compared to the baseline. Other criteria were the dynamics of each symptom of knee OA according to the WOMAC questionnaire (pain, stiffness, and functional impairment, total score) on each visit, pain intensity in the target joint on a visual analogue scale (VAS), time it takes to travel 15 m, and the patient's overall disease assessment on the VAS. In addition, duration of use and dose of paracetamol (if used) were assessed, as well as quality of life by EuroQol and adverse events (AEs). Treatment safety was also analyzed in patients who had received at least one dose of the study drug. Results and discussion. WOMAC pain intensity decreased by on average of 3.8 points: from 7.6 to 3.8 points (95 % confidence interval, CI from -4.3 to -3.3). Data on changes in knee OA symptoms (pain, stiffness, and functional impairment) for each WOMAC subscale and the total score showed significant improvement at each follow-up visit (p < 0.0001). The VAS pain level decreased by 52%. An improvement in joint function was noted: the time it takes to travel 15 m fell from 19.5 to 16.4 s (p < 0.0001). The EuroQol quality of life score also improved from 57.1 ± 16.2 points at baseline to 71.1 ± 14.8 points on the 84<sup>th</sup> day of therapy. Thirty (25.2 %) patients had AEs, mainly neurological: headache (7.6 %) and hypoesthesia (1.7 %). No serious AEs were recorded. An association between AEs and study drug use was noted in 4 patients (headache, hypoesthesia, muscle cramps, and injection site pain). Conclusion. The results of the study confirm the efficacy and safety of the use of Traumeel® S and Zeel® T in patients with knee OA who have concomitant cardiovascular disease. During therapy, a significant decrease in pain and other clinical signs of OA (stiffness, limitation of physical activity) was observed, which allows us to recommend this treatment regimen for patients with comorbid pathology, as well as with the risk of developing of AEs during non-steroidal anti-inflammatory drugs therapy.

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Results of a clinical study of Traumeel® S and Zeel® T in patients with knee osteoarthritis and concomitant cardiovascular disease

Alekseeva,

Mazurov,

Zonova

et al. 2023

Sovremennaâ revmatologiâ

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Orthovoltage X-Ray Therapy Significantly Reduces Disability Risk In Knee Osteoarthritis Patients: A Decade-Long Cohort Study

Makarova,

Valkov,

Grjibovski

2023

Russ Open Med J

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Introduction — Osteoarthritis (OA) of the knee and hip joints affects 13% of the adult population in the Russian Federation. While medications can provide some relief from the pain associated with OA, they are often not enough. An alternative treatment option is orthovoltage radiation therapy (OVRT), which not only relieves pain, but can also help prevent disability. However, there is little evidence for the long-term effectiveness of OVRT. Objective — We compared the incidence of disability among patients with OA who received standard treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) in combination with the symptomatic slow-acting drugs for osteoarthritis (SYSADOA), or in combination with OVRT for knee OA in the setting of an open randomized controlled trial with long-term follow-up. Material and Methods — The sampling frame included patients with confirmed OA of the knee sensu Altman (1991), with radiographic grades of OA from 0 to 2 sensu Kellgren-Lawrence. A total of 292 patients were randomly distributed among two groups of equal sizes. The control group received combination therapy with NSAIDs and SYSADOA. In the experimental group, OVRT was additionally performed at a total dose of 4.5 Gy. Relationships between treatment regimen and time to disability were studied using actuarial analysis, Kaplan-Meier plots. Crude and adjusted hazard ratios (HR) with 95% confidence intervals (CI), as well as attributable fraction (AF) and population attributable fraction (PAF) were calculated. Results — The cumulative time at risk for disability was 2,304.9 person-years. In total, 9.5% of patients in the experimental group became disabled during the observation period vs. 17.8% in the control group. In the experimental group, the level of disability was lower (HR=0.49, 95% CI: 0.26-0.95). Differences became more pronounced after adjusting for sex, age, radiographic grade of OA, pain intensity, and duration of OA before treatment (HR=0.24, 95% CI: 0.11-0.48). AF and PAF were 49.9% and 25.8%, respectively. Conclusion — It has been shown that the introduction of OVRT in the treatment regimen can reduce the disability of patients with knee OA by almost 50%. One in four disability cases could be prevented if OVRT were used universally in the treatment of knee OA. Our results indicate that combining OVRT with standard care is a more effective approach to preventing disability in patients with knee OA than standard treatment alone.

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Postmyocardial syndrome after myocardial infarction and percutaneous coronary intervention

Klimenko,

Demidova,

Veselkin

et al. 2024

Racionalʹnaâ farmakoterapiâ v kardiologii

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Postmyocardial syndrome (Dressler syndrome) is a form of secondary pericarditis with or without pericardial effusion resulting from myocardial damage. Dressler syndrome is not a common disease, but it should be suspected in patients with pathognomonic symptoms after a myocardial infarction (MI). The article presents a clinical case of a 65-year-old man, a smoker who is overweight, with a history of hypertension, MI with ST segment elevation, stenting of the envelope branch of the left coronary artery, thrombospiration. According to coronary angiography, the patient revealed a multivessel lesion of the coronary arteries. Two weeks after stenting, the patient’s condition worsened: shortness of breath, pain in the left half of the chest, fever appeared. During the examination at the outpatient stage, bilateral hydrothorax and hydropericardium were revealed. He was hospitalized, was treated with ibuprofen 600 mg 3 times a day for 7 days, with a positive effect. Ten days after discharge, the patient noted an increase in shortness of breath, an increase in body temperature, a recurrence of dull chest pain. He was hospitalized at the Vorokhobov City Clinical Hospital No. 67, where bilateral hydrothorax, hydropericardium, pneumonitis were detected during the examination. the diagnosis "Postmyocardial syndrome, recurrent course" was established. Hospital treatment was carried out with colchicine, methylprednisolone, acetylsalicylic acid, ticagrelor, losartan, bisoprolol, amlodipine, spironolactone. Against the background of the therapy, the condition improved, the patient began to notice an increase in exercise tolerance, a gradual regression of dull chest pain on the left, body temperature decrease to subfebrile figures. Positive dynamics of laboratory parameters was noted.

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Adverse Reactions of the Cardiovascular System when Taking Nonsteroidal Anti-inflammatory Drugs and Ways to Reduce Them

Cited by 5 publications

References 42 publications

Results of a clinical study of Traumeel® S and Zeel® T in patients with knee osteoarthritis and concomitant cardiovascular disease

Results of a clinical study of Traumeel® S and Zeel® T in patients with knee osteoarthritis and concomitant cardiovascular disease

Orthovoltage X-Ray Therapy Significantly Reduces Disability Risk In Knee Osteoarthritis Patients: A Decade-Long Cohort Study

Postmyocardial syndrome after myocardial infarction and percutaneous coronary intervention

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