从亚洲蒿中提取的DA-9601含有一种生物活性化合物-eupatilin-可以通过抗炎和抗氧化特性防止胃粘膜损伤,并在韩国被批准用于治疗急性和慢性胃炎,但其对非甾体类抗炎药(NSAIDs)引起的胃肠道(GI)出血的保护能力尚不清楚.我们旨在使用韩国健康保险评论和评估数据库,比较DA-9601与质子泵抑制剂(PPI)和瑞巴派特对接受长期NSAIDs治疗的类风湿关节炎(RA)患者的上消化道和下消化道出血的保护作用。在这项全国性的回顾性队列研究中,我们评估了同时接受NSAIDs治疗3个月以上的RA患者DA-9601,PPI,或rebamipide在2015年1月至2017年12月之间。索引日期是NSAIDs开始的日期,所有患者均随访至2020年12月,以检测上消化道和下消化道出血.总的来说,24,258例RA患者符合条件,和5468(22.5%),4417(18.2%),和14373(59.3%)收到DA-9601,PPI,或者rebamipide,分别,在索引日期。随访期间,508例(2.1%)和402例(1.6%)RA患者发生上消化道和下消化道出血,分别。上消化道和下消化道出血的发生率分别为615/100,000和485/100,000人年,分别。在接受DA-9601,PPI的RA患者中,或者rebamipide,NSAIDs引起的上消化道出血的频率为0.5%,0.4%,和1.2%,分别。NSAIDs引起的下消化道出血的频率为0.4%,0.4%,和0.9%,分别。在接受DA-9601、PPI、瑞巴派特分别为601/100,000、705/100,000和596/100,000人年,分别,而同一组NSAIDs引起的下消化道出血的发生率为449/100,000、608/100,000和465/100,000人年,分别。在多元Cox回归分析中,RA患者使用DA-9601、PPI、还有瑞巴派特.我们的结果表明,DA-9601可能对NSAIDs引起的胃肠道出血具有保护作用,与PPI和瑞巴派特在RA患者中的作用相当。
DA-9601 extracted from Artemisia asiatica contains a bioactive compound - eupatilin - that can protect against gastric mucosal damage through anti-inflammatory and anti-oxidative properties and is approved for treating acute and chronic gastritis in Korea, but their ability to protect gastrointestinal (GI) bleeding caused by nonsteroidal anti-inflammatory drugs (NSAIDs) is unclear. We aimed to compare the protective effects of DA-9601 to those of proton pump inhibitors (PPI) and rebamipide against upper and lower GI bleeding in patients with rheumatoid arthritis (RA) undergoing long-term NSAIDs therapy using the Korean Health Insurance
Review and Assessment database. In this nationwide retrospective cohort study, we evaluated patients with RA who concurrently received NSAIDs for >3 months with DA-9601, PPI, or rebamipide between January 2015 and December 2017. The index date was the date of NSAIDs initiation, and all patients were followed up until December 2020 to detect upper and lower GI bleeding. In total, 24,258 patients with RA were eligible, and 5468 (22.5%), 4417 (18.2%), and 14,373 (59.3%) received DA-9601, PPI, or rebamipide, respectively, on the index date. During follow-up, upper and lower GI bleeding occurred in 508 (2.1%) and 402 (1.6%) patients with RA, respectively. The incidence rate of upper and lower GI bleeding was 615/100,000 and 485/100,000 person-years, respectively. Among patients with RA receiving DA-9601, PPI, or rebamipide, the frequencies of NSAIDs-induced upper GI bleeding were 0.5%, 0.4%, and 1.2%, respectively. The frequencies of NSAIDs-induced lower GI bleeding were 0.4%, 0.4%, and 0.9%, respectively. The incidence of NSAIDs-induced upper GI bleeding in patients with RA receiving DA-9601, PPI, and rebamipide was 601/100,000, 705/100,000, and 596/100,000 person-years, respectively, while the incidence of NSAIDs-induced lower GI bleeding in the same groups was 449/100,000, 608/100,000, and 465/100,000 person-years, respectively. In the multivariate Cox regression analysis, no significant difference was observed in lower and upper GI bleeding hazards between patients with RA using DA-9601, PPI, and rebamipide. Our results suggest that DA-9601 may exhibit protection against NSAIDs-induced GI bleeding that is comparable to those of PPI and rebamipide in patients with RA.