The use of NSAIDs in rheumatic disorders 2005: a global perspective.

摘要: Population studies and World Health Organisation (WHO) statistics indicate that 10–50% of individuals suffer from musculoskeletal disorders. Up to 3% will be classified as disabled due their bone joint condition, the majority pain. Almost all require non-steroidal anti-inflammatory drugs (NSAIDs) other analgesics for management. The large this population is elderly and, hence, at greater risk adverse effects NSAIDs. NSAIDs are a necessary choice in pain management because integrated role cyclo-oxygenase (COX) pathway generation inflammation biochemical recognition For over 80 years was hampered by NSAID toxicity problems related traditional In early 1990s, paracetamol recommended first-choice analgesic osteoarthritis, but subsequent have shown has significant gastrointestinal (GI) profile. addition, it lower efficacy than is, thus, not an effective alternative any inflammatory arthritides. identification 2 (COX-2) introduction COX-2-selective inhibitor thought major breakthrough with expectation reduction G/I side-effects. This been case celecoxib, indeed inhibitors when given ASA. also inhibit renal COX-2 potential fluid retention, oedema, hypertension congestive heart failure. controversy respect class increase myocardial infarction cardiovascular events observed some studies. Thus, initial expected global benefits may outweighed toxicity. Recent use proton-pump drug significantly reduce GI symptoms peptic ulceration. re-established preferred arthritis