Consideraciones de seguridad en la prescripción de medicamentos antiinflamatorios no esteroideos (AINEs), a través de una revisión de revisiones sistemáticas

Autores/as

  • A. Olry de Labry Lima Andalusian School of Public Health (EASP). Campus Universitario de Cartuja. Granada. Spain.
  • E. Salamanca-Fernández Radiology and Physical Medicine Department. University of Granada. Granada. Spain.
  • E.J. Alegre del Rey Pharmacy Service. Hospital Universitario Puerto Real. Cádiz. Spain.
  • A. Matas Hoces Andalusian School of Public Health (EASP). Campus Universitario de Cartuja. Granada. Spain.
  • M.Á. González Vera Farmacia del Puente. Pinos Puente. Granada. Spain.
  • C. Bermúdez Tamayo Andalusian School of Public Health (EASP). Campus Universitario de Cartuja. Granada. Spain.

DOI:

https://doi.org/10.23938/ASSN.0965

Palabras clave:

AINEs, Enfermedad cardiovascular, Hipertensión, Revisión paraguas

Resumen

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs worldwide. This makes it necessary to carry out a comprehensive synthesis of the available evidence on the safe and adequate prescription of NSAIDs in patients with cardiovascular disease, chronic kidney disease, hypertension, heart failure or liver cirrhosis and in general population. For this, a review of systematic reviews was carried out. Data extraction and analysis were performed independently by two reviewers and a narrative synthesis of the results was carried out. The use of NSAIDs is associated with a significantly higher probability of hepatotoxicity and kidney damage, as well as increased risk of exacerbation of heart failure. Taking into account the increased cardiovascular, liver and kidney risk, the prescription of NSAIDs should be carried out with caution, considering the treatment duration and the patient’s situation. For this reason, patients should be informed about their possible health consequences as well as ensuring adequate monitoring of them.

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Biografía del autor/a

A. Olry de Labry Lima, Andalusian School of Public Health (EASP). Campus Universitario de Cartuja. Granada. Spain.

CIBER of Epidemiology and Public Health (CIBERESP). Spain.

Instituto de Investigación Biosanitaria de Granada. Granada. Spain.

E. Salamanca-Fernández, Radiology and Physical Medicine Department. University of Granada. Granada. Spain.

 

2. CIBER of Epidemiology and Public Health (CIBERESP). Spain.

3. Instituto de Investigación Biosanitaria de Granada. Granada. Spain.

A. Matas Hoces, Andalusian School of Public Health (EASP). Campus Universitario de Cartuja. Granada. Spain.

CADIME: Andalusian Medicine Information Center. Granada. Spain.

C. Bermúdez Tamayo, Andalusian School of Public Health (EASP). Campus Universitario de Cartuja. Granada. Spain.

CIBER of Epidemiology and Public Health (CIBERESP). Spain

Instituto de Investigación Biosanitaria de Granada. Granada. Spain.

Citas

LOZA E. AINEs en la práctica clínica: lo que hay que saber. Inf Ter Sist Nac Salud 2011; 35: 88-95.

Ministerio de Sanidad, Servicios Sociales e Igualdad. Gobierno de España. Utilización de medicamentos antiinflama-torios no esteroideos en España durante el periodo 2013-2016. Informe de utilización de medicamentos U/AIN/V1/11/09/2017. https://www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/antiinflamatorios-AINEs-periodo-2013-2016.pdf

WELSBY PD. WHO analgesic ladder. Treasure Island: StatPearls Publishing 2008; 284.

BREIVIK H, COLLETT B, VENTAFRIDDA V, COHEN R, GALLACHER D. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain 2006; 10: 287-333. https://doi.org/10.1016/j.ejpain.2005.06.009

UBEDA A, FERRÁNDIZ ML, MAICAS N, GOMEZ C, BONET M, PERIS JE. [Potentially inappropriate prescribing in institu-tionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria]. Pharm Pract 2012; 10: 83-91 https://doi.org/10.4321/s1886-36552012000200004

RISSER A, DONOVAN D, HEINTZMAN J, PAGE T. NSAID prescribing precautions. Am Fam Physician 2009; 80: 1371-1378.

SMITH V, DEVANE D, BEGLEY CM, CLARKE M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol 2011; 11: 1-6. https://doi.org/10.1186/1471-2288-11-15

Ministerio de Sanidad. Gobierno de España. Red Española de Agencias de Evaluación de Tecnologías Sanitarias y Prestaciones del Sistema Nacional de Salud. https://redets.sanidad.gob.es/

BOUGIOUKAS KI, BOURAS E, APOSTOLIDOU-KIOUTI F, KOKKALI S, ARVANITIDOU M, HAIDICH A-B. Reporting guide-lines on how to write a complete and transparent abstract for overviews of systematic reviews of health care inter-ventions. J Clin Epidemiol 2019; 106: 70-79. https://doi.org/10.1016/j.jclinepi.2018.10.005

SHEA BJ, REEVES BC, WELLS G, THUKU M, HAMEL C, MORAN J et al. AMSTAR 2: A critical appraisal tool for sys-tematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; 358. https://doi.org/10.1136/bmj.j4008

SRIUTTHA P, SIRICHANCHUEN B, PERMSUWAN U. Hepatotoxicity of nonsteroidal anti-inflammatory drugs: a systemat-ic review of randomized controlled trials. Int J Hepatol 2018. https://doi.org/10.1155/2018/5253623

NDERITU P, DOOS L, JONES PW, DAVIES SJ, KADAM UT. Non-steroidal anti-inflammatory drugs and chronic kidney disease progression: A systematic review. Fam Pract 2013; 30: 247-255. https://doi.org/10.1093/fampra/cms086

ZHANG X, DONNAN PT, BELL S, GUTHRIE B. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and me-ta-analysis. BMC Nephrol 2017; 18: 256. https://doi.org/10.1186/s12882-017-0673-8

ASGHAR W, JAMALI F. The effect of COX-2-selective meloxicam on the myocardial, vascular and renal risks: a sys-tematic review. Inflammopharmacology 2014; 23: 1-16. https://doi.org/10.1007/s10787-014-0225-9

YAXLEY J, LITFIN T. Non-steroidal anti-inflammatories and the development of analgesic nephropathy: a systematic review. Ren Fail 2016; 38: 1328-1334. https://doi.org/10.1080/0886022x.2016.1216708

VILLA J, CANO A, FRANCO D, MONSALVE M, HINCAPIÉ J, AMARILES P. [Clinical relevance of drug interactions be-tween nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives]. Aten Primaria 2014; 46: 464-474 https://doi.org/10.1016/j.aprim.2013.11.010

UNGPRASERT P, SRIVALI N, THONGPRAYOON C. Nonsteroidal anti-inflammatory drugs and risk of incident heart failure: a systematic review and meta-analysis of observational studies. Clin Cardiol 2016; 39: 111-118. https://doi.org/10.1002/clc.22502

LIU G, YAN YP, ZHENG XX, XU YL, LU J, HUI RT et al. Meta-analysis of nonsteroidal anti-inflammatory drug use and risk of atrial fibrillation. Am J Cardiol 2014; 114: 1523-1529. https://doi.org/10.1016/j.amjcard.2014.08.015

SESHASAI SRK, WIJESURIYA S, SIVAKUMARAN R, NETHERCOTT S, ERQOU S, SATTAR N et al. Effect of aspirin on vas-cular and nonvascular outcomes: meta-analysis of randomized controlled trials. Arch Intern Med 2012; 172: 209-216. https://doi.org/10.1001/archinternmed.2011.628

WHITLOCK EP, BURDA BU, WILLIAMS SB, GUIRGUIS-BLAKE JM, EVANS C V. Bleeding risks with aspirin use for pri-mary prevention in adults: a systematic review for the U.S. preventive services task force. Ann Intern Med 2016; 164: 826-835. https://doi.org/10.7326/m15-2112

BOULAKH L, GISLASON GH. Treatment with non-steroidal anti-inflammatory drugs in patients after myocardial in-farction – a systematic review. Expert Opin Pharmacother 2016; 17: 1387-1394. https://doi.org/10.1080/14656566.2016.1186648

UNGPRASERT P, SRIVALI N, KITTANAMONGKOLCHAI W. Non-steroidal anti-inflammatory drugs and risk of heart failure exacerbation: A systematic review and meta-analysis. Eur J Intern Med 2015; 26: 685-690. https://doi.org/10.1016/j.ejim.2015.09.012

GARCÍA RODRÍGUEZ LA, GONZÁLEZ-PÉREZ A, BUENO H, HWA J. NSAID use selectively increases the risk of non-fatal myocardial infarction: A systematic review of randomised trials and observational studies. PLoS One 2011; 6: e16780. https://doi.org/10.1371/journal.pone.0016780

SALVO F, FOURRIER-RÉGLAT A, BAZIN F, ROBINSON P, RIERA-GUARDIA N, HAAG M et al. Cardiovascular and gastro-intestinal safety of NSAIDs: A systematic review of meta-analyses of randomized clinical trials. Clin Pharmacol Ther 2011; 89: 855-866. https://doi.org/10.1038/clpt.2011.45

SCOTT PA, KINGSLEY GH, SCOTT DL. Non-steroidal anti-inflammatory drugs and cardiac failure: meta-analyses of observational studies and randomised controlled trials. Eur J Heart Fail 2008; 10: 1102-1107. https://doi.org/10.1016/j.ejheart.2008.07.013

VARAS-LORENZO C, RIERA-GUARDIA N, CALINGAERT B, CASTELLSAGUE J, SALVO F, NICOTRA F et al. Myocardial infarction and individual nonsteroidal anti-inflammatory drugs meta-analysis of observational studies. Pharmacoepi-demiol Drug Saf 2013; 22: 559-570. https://doi.org/10.1002/pds.3437

MCGETTIGAN P, HENRY D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: Systematic review of population-based controlled observational studies. PLoS Med 2011; 8. https://doi.org/10.1371/journal.pmed.1001098

MACKENZIE IS, WEI L, MACDONALD TM. Cardiovascular safety of lumiracoxib: A meta-analysis of randomised controlled trials in patients with osteoarthritis. Eur J Clin Pharmacol 2013; 69: 133-141. https://doi.org/10.1007/s00228-012-1335-1

MAJOR RW, OOZEERALLY I, DAWSON S, RIDDLESTON H, GRAY LJ, BRUNSKILL NJ. Aspirin and cardiovascular prima-ry prevention in non-endstage chronic kidney disease: A meta-analysis. Atherosclerosis 2016; 251: 177-182. https://doi.org/10.1016/j.atherosclerosis.2016.06.013

LUNI FK, RIAZ H, KHAN AR, RIAZ T, HUSNAIN M, RIAZ I BIN et al. Clinical outcomes associated with per-operative discontinuation of aspirin in patients with coronary artery disease: A systematic review and meta-analysis. Catheter Cardiovasc Interv 2017; 89: 1168-1175. https://doi.org/10.1002/ccd.26807

LEE M, SAVER JL, HONG KS, WU HC, OVBIAGELE B. Risk-benefit profile of warfarin versus aspirin in patients with heart failure and sinus rhythm a meta-analysis. Circ Hear Fail 2013; 6: 287-292. https://doi.org/10.1161/circheartfailure.112.971697

BEM D, LORDKIPANIDZÉ M, HODGKINSON J, STEVENS S, BAYLISS S, MOORE D et al. The effects of different aspirin dosing frequencies and the timing of aspirin intake in primary and secondary prevention of cardiovascular disease: a systematic review. Clin Pharmacol Ther 2016; 100: 500-512. https://doi.org/10.1002/cpt.438

LANAS A, BENITO P, ALONSO J, HERNÁNDEZ-CRUZ B, BARÓN-ESQUIVIAS G, PEREZ-AÍSA Á et al. [Safe prescription recommendations for non steroidal anti-inflammatory drugs: Consensus document ellaborated by nominated experts of three scientific associations (SER-SEC-AEG)]. Reumatol Clin 2014; 10: 68-84. https://doi.org/10.1016/j.reuma.2013.10.004

GISLASON GH, KØBER L, SCHJERNING OLSEN A-M, LOCK HANSEN M, TORP-PEDERSEN C, FOSBØL EL et al. NSAIDs are associated with increased risk of atrial fibrillation in patients with prior myocardial infarction: a nationwide study. Eur Hear J Cardiovasc Pharmacother 2015; 1: 107-114. https://doi.org/10.1093/ehjcvp/pvv004

JONES R, RUBIN G, BERENBAUM F, SCHEIMAN J. Gastrointestinal and cardiovascular risks of nonsteroidal an-ti-inflammatory drugs. Am J Med 2008; 121: 464-474. https://doi.org/10.1016/j.amjmed.2008.01.045

POPE JE, ANDERSON JJ, FELSON DT. A meta-analysis of the effects of nonsteroidal anti-inflammatory drugs on blood pressure. Arch Intern Med 1993; 153: 477-484. https://doi.org/10.1001/archinte.1993.00410040045007

JOHNSON AG, NGUYEN TV, DAY RO. Do nonsteroidal anti-inflammatory drugs affect blood pressure? A me-ta-analysis. Ann Intern Med 1994; 121: 289. https://doi.org/10.7326/0003-4819-121-4-199408150-00011

TRELLE S, REICHENBACH S, WANDEL S, HILDEBRAND P, TSCHANNEN B, VILLIGER PM et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ 2011; 342: 154. https://doi.org/10.1136/bmj.c7086

HOWELL M, WALKER RC, HOWARD K. Cost Effectiveness of dialysis modalities: a systematic review of economic evaluations. Appl Health Econ Health Policy 2019. https://doi.org/10.1007/s40258-018-00455-2

PIEPER D, BUECHTER R, JERINIC P, EIKERMANN M. Overviews of reviews often have limited rigor: a systematic re-view. J Clin Epidemiol 2012; 65: 1267-1273. https://doi.org/10.1016/j.jclinepi.2012.06.015

SOSTRES C, LANAS Á. [Appropriate prescription, adherence and safety of non-steroidal anti-inflammatory drugs]. Med Clin 2016; 146: 267-272. https://doi.org/10.1016/j.medcli.2015.09.022

BRODY H. Promoting conversations between providers and patients. ABIM Foundation. Choosing Wisely 2012. http://www.choosingwisely.org/

National Institute for Health and Care Excellence. NICE “do not do” recommendations. https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines

Ministerio de Sanidad, Consumo y Bienestar Social. Compromiso por la calidad de las Sociedades Científicas en España. Implementación de las recomendaciones de “No Hacer”. 2018. https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/cal_sscc.htm

Publicado

2021-08-20

Cómo citar

Olry de Labry Lima, A., Salamanca-Fernández, E., Alegre del Rey, E., Matas Hoces, A., González Vera, M., & Bermúdez Tamayo, C. (2021). Consideraciones de seguridad en la prescripción de medicamentos antiinflamatorios no esteroideos (AINEs), a través de una revisión de revisiones sistemáticas. Anales Del Sistema Sanitario De Navarra, 44(2), 261–273. https://doi.org/10.23938/ASSN.0965