Coming to terms with nonsteroidal anti-inflammatory drug gastropathy.

Drugs
Sanford H Roth

Abstract

Despite well known complications, oral nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most commonly prescribed medications in the US for musculoskeletal disorders such as osteoarthritis. Although there has been a recent focus on the cardiovascular and renal complications associated with these agents, NSAID gastropathy continues to be a particular concern in many patients, especially those at increased risk for serious adverse events, including the elderly. Complicating the diagnosis of NSAID gastropathy is its silent course, which, up to half of the time, is asymptomatic. Several strategies are currently employed by physicians to mitigate the risk of serious gastrointestinal events. These include either addition of a proton pump inhibitor to current nonselective NSAID therapy or the use of a cyclo-oxygenase-2-selective NSAID. Although these agents are effective at mitigating the overall risk of gastrointestinal adverse events, they fail to address NSAID-related cardiovascular and renal risks. Due to their reduced systemic absorption, topical NSAIDs may present a viable option for patients at increased risk for serious NSAID-related adverse events, including gastropathy.

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Citations

Dec 24, 2013·Rheumatology International·Sergio GimenezBárbara Fernández-Morales
Dec 22, 2017·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Hu ChenNingjia He
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Nov 18, 2018·Journal of Ethnopharmacology·Camila CamponogaraSara Marchesan Oliveira

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