PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: To assess the renal risks of coxibs compared to placebo by means of a systematic review and meta-analysis.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: To assess the renal risks of coxibs compared to placebo by means of a systematic review and meta-analysis.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■选择性环氧合酶-2抑制剂抗炎药（coxibs）与不良事件的发展有关，主要是胃肠道和心血管，但对肾脏的影响却鲜为人知.
■通过系统评价和荟萃分析评估coxibs与安慰剂相比的肾脏风险。
■评估coxibs的肾脏影响的随机对照试验（塞来昔布，依托考昔,lumiracoxib,帕瑞昔布,和伐地考昔)在PubMed中搜索，Embase,截至2024年3月，Scopus和其他来源。两名独立审核员进行了研究筛选，数据提取,和偏见风险评估。采用随机效应荟萃分析来计算与安慰剂相比，coxibs的肾脏效应的相对风险（RR）和95％置信区间（CI）以及研究之间的不一致性（I2）。使用建议分级评估来评估证据的确定性，开发和评估方法。
■在5284条检索记录中，包括49项研究（包括46份报告）。Coxibs增加了水肿的风险(RR1.46;95%CI1.15,1.86;I2=0%;34项研究,19,754名参与者；中等确定性证据)，和塞来昔布增加了高血压或肾脏事件（RR1.24;95％CI1.08，1.43;I2=0％;2项研究，3589名参与者；中度确定性证据)。依托考昔增加高血压的风险(RR1.98;95%CI1.14,3.46;I2=34%;13项研究,6560名参与者；中度确定性证据）；合并所有coxibs时没有观察到差异（RR1.26；95%CI0.91，1.76；I2=26%；30项研究，16,173名参与者；中等确定性证据)。
■考克斯可能会增加肾脏的不良反应，包括高血压和水肿。应该提高对coxibs的肾脏风险的认识，主要是高危患者。
■通过系统评价和荟萃分析评估coxibs与安慰剂相比的肾脏风险。
■评估coxibs的肾脏影响的随机对照试验（塞来昔布，依托考昔,lumiracoxib,帕瑞昔布,和伐地考昔)在PubMed中搜索，Embase,截至2024年3月，Scopus和其他来源。两名独立审核员进行了研究筛选，数据提取,和偏见风险评估。采用随机效应荟萃分析来计算与安慰剂相比，coxibs的肾脏效应的相对风险（RR）和95％置信区间（CI）以及研究之间的不一致性（I2）。使用建议分级评估来评估证据的确定性，开发和评估方法。
■在5284条检索记录中，包括49项研究（包括46份报告）。Coxibs增加了水肿的风险(RR1.46;95%CI1.15,1.86;I2=0%;34项研究,19,754名参与者；中等确定性证据)，和塞来昔布增加了高血压或肾脏事件（RR1.24;95％CI1.08，1.43;I2=0％;2项研究，3589名参与者；中度确定性证据)。依托考昔增加高血压的风险(RR1.98;95%CI1.14,3.46;I2=34%;13项研究,6560名参与者；中度确定性证据）；合并所有coxibs时没有观察到差异（RR1.26；95%CI0.91，1.76；I2=26%；30项研究，16,173名参与者；中等确定性证据)。
■考克斯可能会增加肾脏的不良反应，包括高血压和水肿。应该提高对coxibs的肾脏风险的认识，主要是高危患者。
