Assessing the Cardiovascular Risk Between Celecoxib and Nonselective Nonsteroidal Antiinflammatory Drugs in Patients With Rheumatoid Arthritis and Osteoarthritis:– A 3-Year Nationwide Comparative Observational Study in Japan (ACCEPT) –
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概要
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Background: A prospective, 3-year comparative observational study compared the risk of cardiovascular events in patients with osteoarthritis or rheumatoid arthritis prescribed celecoxib or a nonsteroidal antiinflammatory drug (NSAID). Methods and Results: Patients prescribed celecoxib (n=5,470) or NSAIDs (n=5,059) between November 1, 2007, and July 31, 2008 in 1,084 hospitals and clinics in Japan were eligible for safety analysis. Mean (standard deviation) observation for the celecoxib group was 716 (420) days and 692 (426) days for the NSAID group (P=0.004). Composite I (adjudicated cardiovascular adverse events of myocardial infarction, angina pectoris, heart failure, cerebral infarction, cerebral hemorrhage) number of events (percentage) and rate/1,000 person years was 66 (1.2%) and 6.2 (10,745 person years), respectively, for the celecoxib and 65 (1.3%) and 6.8 (9,601 person years) for the NSAID (P=0.58) groups. Composite II (all cardiovascular events) number of events (percentage) and rate/1,000 person years was 79 (1.4%) and 7.4, respectively, for the celecoxib and 84 (1.7%) and 8.8 for the NSAID (P=0.26) group. Adjusted Cox hazards ratio (95% confidence interval) was 0.89 (0.63–1.27; P=0.52) for Composite I, 0.87 (0.63–1.19; P=0.39) for Composite II and 1.03 (0.75–1.41; P=0.87) for death from all causes. Conclusions: After adjustment for confounding variables, celecoxib was not associated with an increase of cardiovascular risk in comparison with nonselective NSAID in Japanese patients with rheumatoid arthritis or osteoarthritis in an observational setting.
- 一般社団法人 日本循環器学会の論文
著者
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KAWAI Shinichi
Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine
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Daida Hiroyuki
Department Of Cardiology
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Tanahashi Norio
Department Of Anesthesiology Osaka University Medical School
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Ishiguro Naoki
Department Of Biotechnology Graduate School Of Engineering Osaka University
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Hirayama Atsushi
Division Of Cardiology Department Of Internal Medicine Nihon University School Of Medicine
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Kawai Shinichi
Division Of Rheumatology Department Of Internal Medicine (omori) School Of Medicine Faculty Of Medicine
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Tanahashi Norio
Department of Neurology, Saitama Medical University, International Medical Center
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Chachin Motohiko
Medical Affairs, Pfizer Japan Inc
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Sugioka Toshihiko
Medical Affairs, Astellas Pharma Inc
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Daida Hiroyuki
Department of Cardiovascular Medicine, Juntendo University
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Ishiguro Naoki
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine
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