scholarly journals Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261239
Author(s):  
Bai-Ru Cheng ◽  
Jia-Qi Chen ◽  
Xiao-Wen Zhang ◽  
Qin-Yang Gao ◽  
Wei-Hong Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Confidence Interval ◽  
Risk Ratio ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Biomedical Literature ◽  
Cardiovascular Safety ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Objective To assess the cardiovascular safety of celecoxib compared to non-selective non-steroid anti-inflammatory drugs or placebo. Methods We included randomized controlled trials of oral celecoxib compared with a non-selective NSAID or placebo in rheumatoid arthritis and osteoarthritis patients. We conducted searches in EMBASE, Cochrane CENTRAL, MEDLINE, China National Knowledge Infrastructure, VIP, Wanfang, and Chinese Biomedical Literature Database. Study selection and data extraction were done by two authors independently. The risk of bias was assessed using Cochrane’s risk-of-bias Tool for Randomized Trials. The effect size was presented as a risk ratio with their 95% confidence interval. Results Until July 22nd, 2021, our search identified 6279 records from which, after exclusions, 21 trials were included in the meta-analysis. The overall pooled risk ratio for Antiplatelet Trialists Collaboration cardiovascular events for celecoxib compared with any non-selective non-steroid anti-inflammatory drugs was 0.89 (95% confidence interval: 0.80–1.00). The pooled risk ratio for all-cause mortality for celecoxib compared with non-selective non-steroid anti-inflammatory drugs was 0.81 (95% confidence interval: 0.66–0.98). The cardiovascular mortality rate of celecoxib was lower than non-selective non-steroid anti-inflammatory drugs (risk ratio: 0.75, 95% confidence interval: 0.57–0.99). There was no significant difference between celecoxib and non-selective non-steroid anti-inflammatory drugs or placebo in the risk of other cardiovascular events. Conclusion Celecoxib is relatively safe in rheumatoid arthritis and osteoarthritis patients, independent of dose or duration. But it remains uncertain whether this would remain the same in patients treated with aspirin and patients with established cardiovascular diseases.

scholarly journals Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis

BMJ ◽  
2011 ◽  
Vol 342 (jan11 1) ◽  
pp. c7086-c7086 ◽  
Author(s):  
S. Trelle ◽  
S. Reichenbach ◽  
S. Wandel ◽  
P. Hildebrand ◽  
B. Tschannen ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Cardiovascular Safety ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Electroconvulsive therapy in the continuation and maintenance treatment of depression: Systematic review and meta-analyses

2017 ◽  
Vol 52 (5) ◽  
pp. 415-424 ◽  
Author(s):  
Alby Elias ◽  
Vivek H Phutane ◽  
Sandy Clarke ◽  
Joan Prudic
Keyword(s):  
Confidence Interval ◽  
Electroconvulsive Therapy ◽  
Risk Ratio ◽  
Systematic Reviews ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Risk Of Bias ◽  
Meta Analyses ◽  
Depressive Episodes

Objective: Acute course of electroconvulsive therapy is effective in inducing remission from depression, but recurrence rate is unacceptably high following termination of electroconvulsive therapy despite continued pharmacotherapy. Continuation electroconvulsive therapy and maintenance electroconvulsive therapy have been studied for their efficacy in preventing relapse and recurrence of depression. The purpose of this meta-analysis was to examine the efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy in preventing relapse and recurrence of depression in comparison to antidepressant pharmacotherapy alone. Methods: We searched MEDLINE, Embase, PsycINFO, clinicaltrials.gov and Cochrane register of controlled trials from the database inception to December 2016 without restriction on language or publication status for randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. Two independent Cochrane reviewers extracted the data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and meta-analyses. The risk of bias was assessed using four domains of the Cochrane Collaboration Risk of Bias Tool. Outcomes were pooled using random effect model. The primary outcome was relapse or recurrence of depression. Results: Five studies involving 436 patients were included in the meta-analysis. Analysis of the pooled data showed that continuation electroconvulsive therapy and maintenance electroconvulsive therapy, both with pharmacotherapy, were associated with significantly fewer relapses and recurrences than pharmacotherapy alone at 6 months and 1 year after a successful acute course of electroconvulsive therapy (risk ratio = 0.64, 95% confidence interval = [0.41, 0.98], p = 0.04, risk ratio = 0.46, 95% confidence interval = [0.21, 0.98], p = 0.05, respectively). There was insufficient data to perform a meta-analysis of stand-alone continuation electroconvulsive therapy or maintenance electroconvulsive therapy beyond 1 year. Conclusion: There are only a few randomized trials of continuation electroconvulsive therapy and maintenance electroconvulsive therapy. The preliminary and limited evidence suggests the modest efficacy of continuation electroconvulsive therapy and maintenance electroconvulsive therapy with concomitant pharmacotherapy in preventing relapse and recurrence of depressive episodes for 1 year after the remission of index episode with the acute course of electroconvulsive therapy.

scholarly journals Review: The choice and cardiovascular safety of particular nonsteroidal anti-inflammatory drugs

2018 ◽  
Vol 24 (1) ◽  
pp. 16-21
Author(s):  
Jonas Černeckis ◽  
Austėja Samuolytė ◽  
Greta Baltušytė ◽  
Rugilė Ivanickaitė ◽  
Kristijonas Puteikis
Keyword(s):  
Rheumatoid Arthritis ◽  
European Medicines Agency ◽  
Cardiovascular Safety ◽  
Menstrual Pain ◽  
Over The Counter ◽  
Wide Range ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Effective Use ◽  
Superiority Trials

Abstract Nonsteroidal anti-inflammatory drugs (NSAIDs) are authorized for the relief of pain and inflammation in a wide range of conditions including the discomfort associated with headaches, osteoarthritis, rheumatoid arthritis, and menstrual pain and are available by prescription or over-the-counter (OTC). We reviewed common adverse effects of NSAIDs (especially those related to cardiovascular [CV] system) along with NICE (National Institute for Health and Care Excellence), EMA (European Medicines Agency), and the FDA (U.S. Food and Drug Administration) guidelines for safe and effective use of particular NSAIDs. Furthermore, we examined the NSAIDs market in Lithuania in a period between June 2016 and May 2017 and discussed how well recommendations mentioned above were followed. We emphasized that there was a high percentage of diclofenac prescribed in Lithuania while international guidelines encourage prescribing ibuprofen or naproxen for their relatively lower CV risk. Reviewing past trials, we observed that despite existing guidelines no single NSAID could be considered to be the safest one due to a lack of superiority trials

Meta-Analysis: Cardiovascular Events Associated with Nonsteroidal Anti-inflammatory Drugs

2006 ◽  
Vol 119 (7) ◽  
pp. 552-559 ◽  
Author(s):  
Shelley R. Salpeter ◽  
Peter Gregor ◽  
Thomas M. Ormiston ◽  
Richard Whitlock ◽  
Parminder Raina ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Meta Analysis ◽  
Inflammatory Drugs ◽  
Anti Inflammatory
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