Vol 10, No 1 (2024)
Review paper
Published online: 2024-03-28

open access

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Nonsteroidal anti-inflammatory drugs in clinical practice — are there any new reports?

Dorota Sikorska1, Sławomir Chlabicz2, Grażyna Rydzewska3, Włodzimierz Samborski1, Andrzej Tykarski4, Jarosław Woroń5
Rheumatology Forum 2024;10(1):26-37.

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) show high efficacy in anti-inflammatory and analgesic therapy and are the most widely used drugs worldwide. In addition to their efficacy, the widespread use of NSAIDs has been fostered by their wide availability, especially as some are available without a prescription. Unfortunately, this group of drugs is also fraught with adverse effects, including serious ones. Due to the widespread use of NSAIDs, updated data on this group of drugs is critical for practitioners to make the right therapeutic decisions. Each patient requires individualised therapy because, in the case of NSAIDs, the choice of a specific drug, in relation to the type and nature of pain and potential adverse effects, is very important. Over the years, attempts have been made to develop an algorithm for the selection of NSAIDs according to the risk of developing complications associated with drugs of this group in individual cases, taking into account the so-called 'golden mean' of NSAIDs and the knowledge of interactions between some NSAIDs and cardioprotective acetylsalicylic acid. This study is another attempt to summarise this issue. With the current state of knowledge, resulting primarily from the publication of the large PRECISION study, which is limited to only three molecules, there remains the fundamental question of expanding the knowledge to include such commonly used drugs as diclofenac, ketoprofen, meloxicam and etoricoxib. In addition to the results of the PRECISION study, this version includes a study by an expert group on other NSAIDs on the Polish market and presents an algorithm for selecting NSAIDs according to individual gastroenterological and cardiovascular risk.

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