Zusammenfassung
Im Zuge der Diskussion über die kardiovaskuläre Sicherheit der einst medienwirksam
als neuer Meilenstein der Schmerztherapie angepriesenen selektiven COX-2 Inhibitoren,
die mit den Marktrücknahmen der Präparate Vioxx (Rofecoxib) 2004 und Bextra (Valdecoxib)
2005 gipfelte, geraten nun auch die klassischen NSAR in den Blickpunkt. Wie sicher
sind die "altbewährten" NSAR wirklich bezüglich kardiovaskulärer Ereignisse? Langzeitstudien
belegen ein mit den COX-2 Hemmern vergleichbares Gesamtrisiko. In der perioperativen
Kurzzeitanwendung haben dennoch beide Substanzklassen noch ihren Stellenwert. Sie
sollten jedoch auch hier nur nach gründlicher Risikoabwägung und keinesfalls routinemäßig
eingesetzt werden.
Abstract
Concerning the current discussion about cardiovascular toxicity of the selective COX-2
inhibitors, recently advertised in the media as a new milestone in the management
of pain, culminating in the market withdrawal of the preparations Vioxx (rofecoxib)
in 2004 and Bextra (valdecoxib) in 2005, the classical NSAIDs are now spotlighted.
How safe are the "well established" NSAIDs regarding adverse cardiovascular events?
Long term studies now show a similar overall risk compared to the selective COX-2
inhibitors. The short lasting perioperative administration of both drug classes are
still indicated. However, even here they should be only used after a systematic risk-calculation
and not on a routine basis.
Schlüsselwörter:
NSAR - COXibe - Kardiovaskuläre Ereignisse
Key words:
NSAIDs - Coxibs - Cardiovascular events
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PD Dr. med. Leopold Eberhart
Email: eberhart@staff.uni-marburg.de
Dr. med. Henning Lange
Email: Henning.Lange@med.uni-marburg.de
