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Review
. 2021 Aug 20;44(2):261-273.
doi: 10.23938/ASSN.0965.

Safety considerations during prescription of non-steroidal anti-inflammatory drugs (NSAIDs), through a review of systematic reviews

A Olry de Labry Lima  1 , E Salamanca-Fernández, E J Alegre Del Rey, A Matas Hoces, M Á González Vera, C Bermúdez Tamayo
Affiliations
Review

Safety considerations during prescription of non-steroidal anti-inflammatory drugs (NSAIDs), through a review of systematic reviews

A Olry de Labry Lima et al. An Sist Sanit Navar. .

Abstract
in English, Spanish

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs worldwide. This makes it necessary to carry out a comprehensive synthesis of the available evidence on the safe and adequate prescription of NSAIDs in patients with cardiovascular disease, chronic kidney disease, hypertension, heart failure or liver cirrhosis and in general population. For this, a review of systematic reviews was carried out. Data extraction and analysis were performed independently by two reviewers and a narrative synthesis of the results was carried out. The use of NSAIDs is associated with a significantly higher probability of hepatotoxicity and kidney damage, as well as increased risk of exacerbation of heart failure. Taking into account the increased cardiovascular, liver and kidney risk, the prescription of NSAIDs should be carried out with caution, considering the treatment duration and the patient's situation. For this reason, patients should be informed about their possible health consequences as well as ensuring adequate monitoring of them.

Los medicamentos antiinflamatorios no esteroideos (AINEs) se encuentran entre los medicamentos más consumidos mundialmente. Esto hace necesario realizar una síntesis amplia de la evidencia disponible sobre la prescripción segura y adecuada de AINEs en pacientes con enfermedad cardiovascular, enfermedad renal crónica, hipertensión, insuficiencia cardíaca o cirrosis hepática y en población general. Para ello se ha realizado una revisión de revisiones sistemáticas. El uso de AINEs se asoció a una probabilidad significativamente mayor de hepatotoxicidad y daño renal y un mayor riesgo de exacerbación de la insuficiencia cardíaca. Teniendo en cuenta el aumento del riesgo cardiovascular, hepático y renal, la prescripción de AINEs debe realizarse con cautela, considerando la duración del tratamiento y la situación del paciente. Por ello, se debe informar a los pacientes sobre sus posibles consecuencias para la salud así como garantizar un seguimiento adecuado de los mismos.

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Figure 1
Figure 1. Flow diagram of the review included in the study.
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