Clinical Research On Adverse Drug Reactions Of Rheumatoid Arthritis Therpy

This clinical research on adverse drug reactions (ADR) in 28lcases of patients with rheurnatQid arthritis (RA) was investigated in 11 hospitals of Hefei, Wuhu, Bengbu and Huainan, by means of pharmacoepimiological methods. The results showed that there was significant difference in the incidence of headache (5.26%and 21.43%), convulsion (5.26%and 21.43%), palpitation (6.5 8%and 32.14%), loss of appetite (28.95% and 64.29%) and pyrosis( 11.84% and 32.14%), after treatment with one nonsteroidal antiinflammatory drugs(NSAID) plus one slow-acting antriheumatic drug(SAARD) and two or more NSAIDs plus one SAARD. It showed the ADR incidence rate of two or more NSAIDs plus SAARD was higher. The incidence of loss of appetite (44.83%and 28.95%) caused by one NSAID plus two SAARDs was higher than one NSAID plus one SAARD with signicance. Whereas, the significant difference existed in the occurrence of feadache (23.08% and 5.26%), vertigo (38.46% and 7.89%), insomnia (23.08% and 5.26%), sickness (46.15% and 17.11%), stomachache (34.62% and 789%), diarrhea(23.06 and 2.63%) and erythra(15.38 and 0) between two or more NSAIDs plus two SAARDs and one NSAID plus one SAARDs, which suggested that the ADR incidence of two or more NSAIDs with two SAARDs was increased remarkably. When methotrexate (MTX) and sulfasalazine (SSZ), combined respectively with selective COX-2 inhibitor (nabumetone (NAB) and nimesulide (NIM)) and unselective COX-2 inhibitor (naproxen (NAP), oxaprozin (QXA), ibuprofen (IBU) and indomethacin (IND)), the ADR incidence rates of two combinations were different. It was found that the ADR incidences of unselective COX-2 inhibitor conbined with SAARDs were higher with significance on the incidence 4 of stomachache caused by MTX with NAB and MTX with NAP (8.56% and 23.37%), sickness caused by MTX with NAB and MTX with IDN (29.27% and 50.0%), vertigo caused by MIX with NIM and MTX with NAP (6.9% and 18.64%), pyrosis caused by SSZ with NIM and SSZ with NAP (7.4% and 32.0%), or drowsiness caused by SSZ with NAB and SSZ with OXA (2.2% and 25.9%), the ADR incidence of selective COX-2 inhibitor combined with one SAARD waas higher with significance on the incidence of vomiting caused by MIX with NAB and MTX with IBU (10.98% and 1.4%), vertigo caused by SSZ with NAB and SSZ with IDN (26.7% and 4.3%),or vertigo caused by SSZ with NAB and SSZ with IDN (26.7% and 4.3%). From above, it suggested that the unreasonable drug combination increased the incidence of the ADR strikingly. In addition, on the aspect of reducing ADR, selective COX-2 inhibitor was not much better than unselective COX-2 inhibitor. From that, arouses thoughts on ADR reduction and provides new ideas on drug research in the future.