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《COST EFFECTIVENESS OF REPLACING DICLOFENAC WITH A FIXEDCOMBINATION OF MISOPROSTOL AND DICLOFENAC IN PATIENTWITH RHEUMATOID ARTHRITISS固定双氯芬酸的成本-效果 米索前列醇与双氯芬酸的联合应用 类风湿性关节炎》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、ARTHRITIS&RHEUMATISMVol.42,No.11,November1999,pp2293±2302©1999,AmericanCollegeofRheumatology2293COSTEFFECTIVENESSOFREPLACINGDICLOFENACWITHAFIXEDCOMBINATIONOFMISOPROSTOLANDDICLOFENACINPATIENTSWITHRHEUMATOIDARTHRITISIVARSéNBéKRISTIANSEN,TOREKRISTIANKVIEN,andERIKNORDObjective.Toestimatethecostsand
2、healthcon-Nonsteroidalantiinflammatorydrugs(NSAIDs)sequencesofreplacingtreatmentwithdiclofenac50mgareinwidespreaduse,butcancausepepticulcersandwithafixedcombinationofdiclofenac50mgandgastrointestinal(GI)bleedingandperforation(1±3).misoprostol0.2mg3timesadayinpatientswithTheriskofsuchcomplicatio
3、nsinrheumatoidarthritisrheumatoidarthritis(RA).(RA)patientstakingNSAIDsmaybe6timesthatinRAMethods.Adecisiontreewasdevelopedtosimu-patientsnottakingNSAIDs(4).AccordingtoFries,thelate6monthsofnonsteroidalantiinflammatorydrugannualriskofdeathorhospitalizationduetoupperGI(NSAID)treatmentforRA.Thepr
4、obabilitiesofthediseaseis1.3±1.6%inRApatientstakingNSAIDs,whileclinicaloutcomeswerebasedonaliteraturereview.Atheratemaybeashighas4±5%incertainhigh-risksurveyofNorwegianrheumatologistswasundertakentogroups(5).exploretheirclinicalmanagementofdyspepsiainRAMisoprostolisasyntheticprostaglandinanalog
5、patientstakingNSAIDs.ValuationofhealthstateswasthatwhentakenalongwithNSAIDs,isshowntobasedonresultsoftheShortForm36healthsurvey.reducetheoccurrenceofendoscopicallyprovengas-Results.InfemaleRApatientswithoutanyrisktricandduodenalulcers(6±11).However,theuseoffactorsassociatedwithseriousgastrointe
6、stinal(GI)misoprostolisitselfassociatedwithminorGIsymp-complications,theincrementalcostofreplacingdiclo-toms,foremostofwhicharediarrheaandabdominalfenacwiththefixedmisoprostol/diclofenaccombinationpain(6±10,12±14).Thissomewhatlimitstheuseful-therapywas$72,700perquality-adjustedlife-yearnessofth
7、isdrug.Additionalcosts,whichshouldtobegained.Forpatientswith1riskfactor,thecostwaslessjustifiedbyitsnethealthbenefits,arealsoincurred.than$16,000.With2or3riskfactors,theuseofThemanyeconomicanalysesaddressingthisissuemisoprostolwas
