Modello valutativo dell'effetto sulla co-prescrizione di gastroprotettoriosservato durante il trattamento dell'artrosi con rofecoxib


Objective: This study was conducted to define an evaluation modelto estimate changes in the co-prescription of gastroprotective agents(GPAs) induced by rofecoxib in the treatment of osteoarthritis (OA).Methods: On the basis of a cross-linking information, which werestored in different administrative and clinical databases, a multivariateregression analysis was used to develop the model. Data were collectedby 30 general practitioners of the Local Health Unit of Ravenna (middle-northof Italy). Results: The study population consisted of 2,944 patientstreated with non-steroidal anti-inflammatory drugs (NSAIDs) and 487treated with rofecoxib. Patients treated with rofecoxib generallypresented a higher number of gastrointestinal damage risk factorsand also a lower level of GPAs co-prescription compared to thosetreated with NSAIDs. Including in the model variables such as typeof anti-inflammatory treatment (NSAIDs or rofecoxib), gender, ageby class, previous hospital admissions due to gastrointestinal complications,number of different NSAIDs used, and prescription of corticosteroids,the regression equation and its coefficients were identified. A non-linearrelationship between the percentage of patients treated with rofecoxiband the relative reduction of GPAs co-prescription was found. Ithas been estimated the basis of the registered percentage of patientstreated with rofecoxib (17,6%) adjusting for gastrointestinal demagerisk factors, and on a 63% (IC95%; 55%-70%) relative reduction ofGPA use with rofecoxib with respect to NSAIDs was estimated. Conclusions:Based on data collected in the clinical practice after the introductionof rofecoxib, a model evaluating the relationship between the frequencyof its use in the OA population and the expected reduction of GPAs,has been developed.

Gianluca Baio
Gianluca Baio
Professor of Statistics and Health Economics