对于有胃肠道出血风险的患者,可以给予质子泵抑制剂。 对于有胃肠道出血史或合并其他疾病的患者,COX-2 抑制剂可能比传统的非甾体抗炎药更安全。[31]Emery P, Zeidler H, Kvien TK, et al. Celecoxib versus diclofenac in long-term management of rheumatoid arthritis: randomized double-blind comparison. Lancet. 1999;354:2106-2111.http://www.ncbi.nlm.nih.gov/pubmed/10609815?tool=bestpractice.com[32]Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial. JAMA. 2000;284:1247-1255.http://jama.ama-assn.org/cgi/content/full/284/10/1247http://www.ncbi.nlm.nih.gov/pubmed/10979111?tool=bestpractice.com
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