RENAL-ASSOCIATED ESCAPE EFFECT OF ANTIHYPERTENSIVE THERAPY IN HYPERTENSIVE PATIENTS RECEIVING NONSTEROIDAL ANTI-INFLAMMA‑ TORY DRUGS (“PANDA” TRIAL)

Abstract

Objective. The subanalysis of the study “PANDA” (the study of renal function in patients with acute nonspecific pain in lower back during therapy with nonsteroidal anti-inflammatory drugs (NSAID)) is the study of renal-associated escape effect of antihypertensive therapy in patients with arterial hypertension (HTN) receiving NSAID. Design and methods. We included 407 patients receiving one of the following NSAIDs for 14 days: meloxicam (15 mg/day), etoricoxib (60 mg/day), nimesulide (200 mg/day) or celecoxib (200 mg/day). Five visits were performed. During the visits blood pressure (BP), glomerular filtration rate (GFR), blood levels of cystatin C were assessed. Results. At first step, all parameters were evaluated in the whole group (n = 407). As the second step, we analyzeds the indicators in 4 groups depending on the NSAID type. At the third stage (subanalysis) we allocated 3 groups of patients: 1 group (n = 62) — patients with a history of HTN and diabetes mellitus, group 2 (n = 173) patients with HTN, and group 3 (n = 172) — patients without HTN and diabetes mellitus. Conclusions . In patients with acute nonspecific back pain, with a history of HTN, NSAID intake is associated with the certain changes in BP, GFR and cystatin-С. Therefore, we can discuss a renal-associated escape effect of antihypertensive therapy. It is the most evident on the 7th day of NSAID therapy. All changes of the studied parameters should be considered as a class-effect adverse reactions of NSAIDs, without any benefits in relation to specific medications.