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Renal effects of selective cyclooxygenase-2 inhibitor anti-inflammatory drugs: A systematic review and meta-analysis.
Biase, Tayanny Margarida Menezes Almeida; Rocha, João Gabriel Mendes; Silva, Marcus Tolentino; Ribeiro-Vaz, Inês; Galvão, Taís Freire.
Afiliación
  • Biase TMMA; School of Pharmaceutical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
  • Rocha JGM; School of Pharmaceutical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
  • Silva MT; Department of Public Health, School of Health Sciences, University of Brasília, Brasília, Brazil.
  • Ribeiro-Vaz I; Department of Community Medicine, Health Information and Decision, School of Medicine, University of Porto, Porto, Portugal.
  • Galvão TF; Center for Health Technology and Services Research, School of Medicine, University of Porto, Porto, Portugal.
Explor Res Clin Soc Pharm ; 15: 100475, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39114538
ABSTRACT

Background:

Selective cyclooxygenase-2 inhibitor anti-inflammatory drugs (coxibs) are associated with the development of adverse events, mainly gastrointestinal and cardiovascular, but renal effects are less known.

Objective:

To assess the renal risks of coxibs compared to placebo by means of a systematic review and meta-analysis.

Methods:

Randomized controlled trials that assessed renal effects of coxibs (celecoxib, etoricoxib, lumiracoxib, parecoxib, and valdecoxib) were searched in PubMed, Embase, Scopus and other sources up to March 2024. Two independent reviewers performed study screening, data extraction, and risk of bias assessment. Random effect meta-analysis was employed to calculate the relative risks (RR) and 95% confidence intervals (CI) of renal effects of coxibs compared to placebo and inconsistency among studies (I 2 ). Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.

Results:

Out of 5284 retrieved records, 49 studies (comprising 46 reports) were included. Coxibs increased the risk of edema (RR 1.46; 95% CI 1.15, 1.86; I 2  = 0%; 34 studies, 19,754 participants; moderate-certainty evidence), and celecoxib increased hypertensive or renal events (RR 1.24; 95% CI 1.08, 1.43; I 2  = 0%; 2 studies, 3589 participants; moderate-certainty evidence). Etoricoxib increased the risk of hypertension (RR 1.98; 95% CI 1.14, 3.46; I 2  = 34%; 13 studies, 6560 participants; moderate-certainty evidence); no difference was observed when pooling all coxibs (RR 1.26; 95% CI 0.91, 1.76; I 2  = 26%; 30 studies, 16,173 participants; moderate-certainty evidence).

Conclusions:

Coxibs likely increase the renal adverse effects, including hypertension and edema. Awareness about the renal risks of coxibs should be increased, mainly in high-risk patient.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Explor Res Clin Soc Pharm Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Explor Res Clin Soc Pharm Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos