Amelioration of Small Bowel Injury by Switching from Nonselective Nonsteroidal Anti-Inflammatory Drugs to Celecoxib in Rheumatoid Arthritis Patients: A Pilot Study
Amelioration of Small Bowel Injury by Switching from Nonselective Nonsteroidal Anti-Inflammatory Drugs to Celecoxib in Rheumatoid Arthritis Patients: A Pilot Study
复制标题
DOI：
10.1159/000357229
复制
发表时间：
2014-01-01
期刊：
影响因子：
3.2
通讯作者：
Takehara, Tetsuo
中科院分区：
文献类型：
--
作者：
Inoue, Takahiro;Iijima, Hideki;Takehara, Tetsuo
背景/目标：非甾体抗炎药（NSAID）广泛用于类风湿关节炎（RA）患者，但有几个副作用，包括小肠粘膜损伤。我们的目的是评估类风湿关节炎患者从非选择性非甾体抗炎药转换为塞来昔布是否可以改善小肠损伤。方法：16例接受非选择性NSAID治疗的RA患者纳入本研究。非选择性NSAID转为塞来昔布治疗12周。在塞来昔布治疗前后进行胶囊内镜检查。视频由对患者治疗不知情的胃肠病学家筛选。结果如下：塞来昔布给药前，分别有63%、63%、88%和69%的患者出现红皱襞、裸露区域、瘀点/红点和粘膜破损。在完成本研究的14例患者中，转换为塞来昔布显著减少了瘀点/红斑的数量、粘膜破损的数量和刘易斯评分。塞来昔布治疗前后外周血RA活性和细胞因子水平无显著差异。结论：非选择性NSAID对RA患者小肠损伤的发生率较高。从非选择性NSAID转换为塞来昔布可用于保护RA患者免受小肠损伤。(C)2014 S. Karger AG，巴塞尔
Background/Aims: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in patients with rheumatoid arthritis (RA) but have several side effects including mucosal damage in the small intestine. We aimed to evaluate whether the small bowel injury is ameliorated by switching from nonselective NSAIDs to celecoxib in patients with RA. Methods: Sixteen patients with RA who were treated with nonselective NSAIDs were enrolled in this study. Nonselective NSAIDs were converted to celecoxib for 12 weeks. Capsule endoscopy was performed before and after treatment with celecoxib. Videos were screened by gastroenterologists blinded to the patients' treatment. Results: Before the administration of celecoxib, reddened folds, denuded areas, petechiae/red spots and mucosa' breaks were observed in 63, 63, 88 and 69% of the patients, respectively. In the 14 patients who completed this study, conversion to celecoxib significantly reduced the number of petechiae/red spots, the number of mucosal breaks, and Lewis scores. RA activity and cytokine levels in the peripheral blood were not significantly different before and after treatment with celecoxib. Conclusions: The incidence of small bowel injury by nonselective NSAIDs is high in patients with RA. Conversion from nonselective NSAIDs to celecoxib can be useful for protecting patients with RA from small bowel injury. (C) 2014 S. Karger AG, Basel