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Current pain and headache reports
Dec, 2007;11 (6): 423-7.

The problem with NSAIDs: what data to believe?

Gayle McKellar, Rajan Madhok, Gurkirpal Singh
Author Information
  1. Gayle McKellar: Center for Rheumatic Diseases, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF, UK. gayle.mckellar@northglasgow.scot.nhs.uk
PMID: 18173976 DOI: 10.1007/s11916-007-0228-y

Abstract

Patients with rheumatoid arthritis and osteoarthritis have relied upon NSAIDs as a cornerstone of their analgesic regime for decades. The choice of anti-inflammatory agents broadened for this group of patients when the selective inhibitors of cyclooxygenase-2 enzyme were developed. Much has been published in the past few years regarding the superior gastrointestinal safety of this class of drugs when compared with traditional NSAIDs. Their triumphant debut was swiftly followed by the emergence of data detailing their associated increased serious cardiovascular risks. This also led to a reevaluation of data concerning more traditional NSAIDs, and surprisingly, a similar trend was seen. The US Food and Drug Administration has recommended that both classes of drugs carry a black box warning with regard to gastrointestinal and cardiovascular risks.

References

  1. Stroke. 2006 Jul;37(7):1725-30 [PMID: 16728684]
  2. N Engl J Med. 2005 Mar 17;352(11):1092-102 [PMID: 15713943]
  3. Arch Intern Med. 1996 Jul 22;156(14):1530-6 [PMID: 8687261]
  4. Int J Clin Pract. 2005 Oct;59(10):1210-7 [PMID: 16178990]
  5. Ann Intern Med. 1994 Aug 15;121(4):289-300 [PMID: 8037411]
  6. JAMA. 2000 Sep 13;284(10):1247-55 [PMID: 10979111]
  7. Heart. 2006 Nov;92 (11):1610-5 [PMID: 16717069]
  8. BMJ. 2006 Jun 3;332(7553):1302-8 [PMID: 16740558]
  9. N Engl J Med. 2004 Oct 21;351(17):1709-11 [PMID: 15470192]
  10. JAMA. 2000 Apr 19;283(15):1967-75 [PMID: 10789664]
  11. Arthritis Rheum. 1995 Jan;38(1):5-18 [PMID: 7818572]
  12. Lancet. 2007 Feb 10;369(9560):465-73 [PMID: 17292766]
  13. Arch Intern Med. 2003 May 12;163(9):1115; author reply 1115-6 [PMID: 12742818]
  14. N Engl J Med. 2001 Mar 29;344(13):967-73 [PMID: 11274623]
  15. N Engl J Med. 2006 Aug 31;355(9):885-95 [PMID: 16943401]
  16. Aliment Pharmacol Ther. 2006 Jan 15;23(2):235-42 [PMID: 16393302]
  17. FASEB J. 1987 Aug;1(2):89-96 [PMID: 3111928]
  18. N Engl J Med. 2006 Aug 31;355(9):873-84 [PMID: 16943400]
  19. Gut. 2006 Dec;55(12):1731-8 [PMID: 16687434]
  20. Arthritis Res Ther. 2006;8(5):R153 [PMID: 16995929]
  21. Arthritis Rheum. 1998 May;41(5):778-99 [PMID: 9588729]
  22. Lancet. 2006 Nov 18;368(9549):1771-81 [PMID: 17113426]
  23. Am J Med. 2006 Mar;119(3):255-66 [PMID: 16490472]
  24. JAMA. 2006 Oct 4;296(13):1633-44 [PMID: 16968831]
  25. J Rheumatol. 2003 Apr;30(4):714-9 [PMID: 12672188]
  26. Circulation. 2007 Mar 27;115(12):1634-42 [PMID: 17325246]
  27. J Pharmacol Exp Ther. 2002 Feb;300(2):367-75 [PMID: 11805193]
  28. Basic Clin Pharmacol Toxicol. 2006 Mar;98(3):266-74 [PMID: 16611201]
  29. Circulation. 2006 Jun 27;113(25):2906-13 [PMID: 16785336]
  30. Arch Intern Med. 2000 Jul 24;160(14):2093-9 [PMID: 10904451]
  31. N Engl J Med. 1999 Jun 17;340(24):1888-99 [PMID: 10369853]
  32. Surg Technol Int. 2003;11:287-92 [PMID: 12931313]
  33. Cochrane Database Syst Rev. 2002;(4):CD002296 [PMID: 12519573]
  34. BMJ. 2007 Jan 20;334(7585):120-3 [PMID: 17235089]
  35. N Engl J Med. 2005 Mar 17;352(11):1071-80 [PMID: 15713944]
  36. Circulation. 2006 Apr 25;113(16):1950-7 [PMID: 16618816]
  37. N Engl J Med. 2000 Nov 23;343 (21):1520-8, 2 p following 1528 [PMID: 11087881]

MeSH Term

Animals
Anti-Inflammatory Agents, Non-Steroidal
Arthritis, Rheumatoid
Cardiovascular Diseases
Cyclooxygenase 2 Inhibitors
Gastrointestinal Diseases
Humans

Chemicals

Anti-Inflammatory Agents, Non-Steroidal
Cyclooxygenase 2 Inhibitors
Journal Article Review

Word Cloud

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