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Journal Club Schmerzmedizin 2013; 2(4): 230-235
DOI: 10.1055/s-0033-1363294
Leitlinien in der Praxis
© Georg Thieme Verlag Stuttgart · New York

Schmerztherapie mit traditionellen NSAR und Coxiben – Eine interdisziplinäre Betrachtung

Wolfgang Fischbach
,
Christoph Baerwald
,
Harald Darius
,
Manfred Gross
,
Georg Nickenig
,
Hubert Nüßlein
,
Dirk O Stichtenoth
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Publikationsverlauf

Publikationsdatum:
08. Januar 2014 (online)

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Nicht steroidale Antirheumatika (NSAR) sind eine der ältesten Wirkstoffgruppen der Menschheit: Seit Jahrtausenden wird die Salizylsäure der Weidenrinde als Wirkprinzip gegen Entzündung und Schmerz genutzt. Eines der ersten großindustriell gefertigten Medikamente war vor über 100 Jahren die Azetylsalizylsäure (ASS), weitere Abkömmlinge kamen in den letzten Jahrzehnten hinzu. Degenerative und entzündlich-rheumatische Gelenkerkrankungen können die Funktionalität des Bewegungssystems und die Lebensqualität der Patienten erheblich beeinträchtigen. Diese Patienten sind auf eine wirksame Schmerzreduktion angewiesen. Dabei zählen traditionelle (nicht selektive) nicht steroidale Antirheumatika (tNSAR) und selektive Cyclooxygenase-(COX-)2-Inhibitoren (Coxibe) zu den am meisten verordneten Medikamenten.

 

  • Literatur

  • 1 Breivik H, Collett B, Ventafridda V et al. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006; 10: 287-333
    Suche in Google Scholar
  • 2 Schaible HG. Epidemiology and pathophysiology of pain – new targets for pain therapy. Med Monatsschr Pharm 2009; 32: 164-171
    Suche in Google Scholar
  • 3 Lanas A, Tornero J, Zamorano JL. Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study. Ann Rheum Dis 2010; 69: 1453-1458
    CrossrefSuche in Google Scholar
  • 4 Stichtenoth DO. Medikamentöse Therapie mit nichtsteroidalen Antirheumatika. In: Pro-CME. 4. Aufl. Stuttgart: Thieme; 2011
    Suche in Google Scholar
  • 5 Moskowitz RW, Sunshine A, Brugger A et al. American pain society pain questionnaire and other pain measures in the assessment of osteoarthritis pain: a pooled analysis of three celecoxib pivotal studies. Am J Ther 2003; 10: 12-20
    CrossrefSuche in Google Scholar
  • 6 Zhao SZ, McMillen JI, Markenson JA et al. Evaluation of the functional status aspects of health-related quality of life of patients with osteoarthritis treated with celecoxib. Pharmacotherapy 1999; 19: 1269-1278
    CrossrefSuche in Google Scholar
  • 7 Sawitzke AD, Shi H, Finco MF et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis 2010; 69: 1459-1464
    CrossrefPubMedSuche in Google Scholar
  • 8 Singh G, Fort JG, Goldstein JL et al. Celecoxib versus naproxen and diclofenac in osteoarthritis patients: SUCCESS-I Study. Am J Med 2006; 119: 255-266
    CrossrefSuche in Google Scholar
  • 9 Simon LS, Weaver AL, Graham DY et al. Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis. JAMA 1999; 282: 1921-1928
    CrossrefSuche in Google Scholar
  • 10 Emery P, Zeidler H, Kvien TK et al. Celecoxib versus Diclofenac in long-term management of rheumatoid arthritis: randomized double-blind comparison. Lancet 1999; 354: 2106-2111
    CrossrefSuche in Google Scholar
  • 11 Dougados M, Behier JM, Jolchine I et al. Efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosing spondylitis: a six-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug. Arthritis Rheum 2001; 44: 180-185
    CrossrefSuche in Google Scholar
  • 12 Sieper J, Klopsch T, Richter M et al. Comparison of two different dosages of celecoxib with diclofenac for the treatment of active ankylosing spondylitis. Ann Rheum Dis 2008; 67: 323-329
    Suche in Google Scholar
  • 13 Wanders A, Heijde D, Landewe R et al. Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis. Arthritis Rheum 2005; 52: 1756-1765
    CrossrefSuche in Google Scholar
  • 14 FitzGerald GA, Patrono C. The Coxibs, selective inhibitors of cyclooxygenase-2. N Engl J Med 2001; 345: 433-442
    CrossrefSuche in Google Scholar
  • 15 Vane JR. Towards a better aspirin. Nature 1994; 367: 215-216
    CrossrefSuche in Google Scholar
  • 16 Stichtenoth DO, Frölich JC. COX 2 and the kidneys. Curr Pharm Des 2000; 6: 1737-1753
    CrossrefSuche in Google Scholar
  • 17 Hinz B, Renner B, Brune K. Drug insight: cyclo-oxygenase-2 inhibitors. A critical appraisal. Nat Clin Pract Rheumatol 2007; 3: 552-560
    CrossrefSuche in Google Scholar
  • 18 Gyllfors P, Bochenek G, Overholt J et al. Biochemical and clinical evidence that aspirin-intolerant asthmatic subjects tolerate the cyclooxygenase 2-selective analgetic drug celecoxib. J Allergy Clin Immunol 2003; 111: 1116-1121
    CrossrefSuche in Google Scholar
  • 19 Stichtenoth DO. The second generation of COX 2 inhibitors: clinical pharmacological point of view. Mini Rev Med Chem 2004; 4: 617-624
    CrossrefSuche in Google Scholar
  • 20 Baigent C, Patrono C. Selective cyclooxygenase 2 inhibitors, aspirin, and cardiovascular disease: a reappraisal. Arthritis Rheum 2003; 48: 12-20
    CrossrefSuche in Google Scholar
  • 21 Chan FK, Ching JY, Hung LC et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 2005; 352: 238-244
    CrossrefSuche in Google Scholar
  • 22 Hunt RH, Lanas A, Stichtenoth DO et al. Myths and facts in the use of anti-inflammatory drugs. Ann Med 2009; 41: 423-437
    CrossrefSuche in Google Scholar
  • 23 Helin-Salmivaara A, Huttunen T, Gronroos JM et al. Risk of serious upper gastrointestinal events with concurrent use of NSAIDs and SSRIs: a case-control study in the general population. Eur J Clin Pharmacol 2007; 63: 403-408
    CrossrefSuche in Google Scholar
  • 24 Spiegel BMR, Farid M, Dulai GS et al. Comparing rates of dyspepsia with coxibs vs NSAID + PPI. Am J Med 2006; 119
    Suche in Google Scholar
  • 25 Rostom A, Muir K, Dube C et al. Gastrointestinal Safety of Cyclooxygenase-2 Inhibitors: a Cochrane Collaboration systematic review. Clin Gastroenterol Hepatol 2007; 5
    Suche in Google Scholar
  • 26 Goldstein JL, Johanson JF, Hawkey CJ et al. Clinical trial: healing of NSAID-associated gastric ulcers in patients continuing NSAID therapy – a randomized study comparing ranitidine with esomeprazole. Aliment Pharmacol Ther 2007; 26: 1101-1111
    CrossrefSuche in Google Scholar
  • 27 Laine L, Smith R, Min K et al. Systematic review: the lower gastrointestinal adverse effects of non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther 2006; 24: 751-767
    CrossrefSuche in Google Scholar
  • 28 Chan F, Lana A, Scheiman J et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet 2010; 376: 173-179
    CrossrefSuche in Google Scholar
  • 29 Laine L, Curtis SP, Langman M et al. Lower gastrointestinal events in a double-blind trial of the cyclo-oxygenase-2 selective inhibitor etoricoxib and the traditional nonsteroidal anti-inflammatory drug diclofenac. Gastroenterology 2008; 135: 1517-1525
    CrossrefSuche in Google Scholar
  • 30 Fischbach W, Malfertheiner P, Hoffmann JC et al. S3-Leitlinie „Helicobacter pylori und gastroduodenale Ulkuskrankheit“ der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS). In Zusammenarbeit mit der Deutschen Gesellschaft für Hygiene und Mikrobiologie, Gesellschaft für Pädiatrische Gastroenterologie und Ernährung e. V. und der Deutschen Gesellschaft für Rheumatologie – AWMF-Register-Nr. 021/001. Z Gastroenterol 2009; 47: 68-102
    Thieme ConnectSuche in Google Scholar
  • 31 Chan F, Wong VWS, Suen BY et al. Combination of a cyclo-oxygenase-2 inhibitor and a proton-pump inhibitor for prevention of recurrent ulcer bleeding in patients at very high risk: a double-blind, randomised trial. Lancet 2007; 369: 1621-1626
    CrossrefSuche in Google Scholar
  • 32 Fischbach W, Darius H, Gross M et al. Positionspapier der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Kardiologie (DGK). Z Gastroenterol 2010; 48: 1-8
    Thieme ConnectSuche in Google Scholar
  • 33 Antiplatelet Trialists Collaboration. Collaborative overview of randomized trials of antiplatelet therapy, I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994; 308: 81-106
    CrossrefSuche in Google Scholar
  • 34 Hernandez-Dıaz S, Varas-Lorenzo C, Rodrıguez L. Non-steroidal antiinflammatory drugs and the risk of acute myocardial infarction. Basic Clin Pharmacol 2006; 98: 266-274
    CrossrefSuche in Google Scholar
  • 35 Chan C, Reid C, Aw T. Do COX-2 inhibitors raise blood pressure more than nonselective NSAIDs and placebo? An updated meta-analysis. J Hypertens 2009; 27: 2332-2341
    CrossrefSuche in Google Scholar
  • 36 Combe B et al. Cardiovascular safety and gastrointestinal tolerability of etoricoxib vs. diclofenac in a randomized controlled clinical trial (The MEDAL study). Rheumatology 2009; 48: 425-432
    CrossrefSuche in Google Scholar
  • 37 White W, West C, Borer J et al. Risk of cardiovascular events in patients receiving celecoxib. Am J Cardiol 2007; 99: 91-98
    CrossrefSuche in Google Scholar
  • 38 Moore RA, Derry S, McQuay H. Cyclo-oxygenase-2 selective inhibitors and nonsteroidal anti-inflammatory drugs: balancing gastrointestinal and cardiovascular risk. BMC Musculoskeletal Disorders 2007; 8
    Suche in Google Scholar
  • 39 Trelle S, Reichenbach S, Wandel S et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ Publishing Group 2011;
    Suche in Google Scholar