NSAIDs are associated with an increased risk of serious gastrointestinal and cardiovascular adverse events, which may be mitigated by dose reduction but require further study for predictive markers.
NSAID use requires careful dose management due to inherent gastrointestinal and cardiovascular risks, with a future need for predictive genetic or biochemical markers.
Conventional medical treatment for rheumatoid arthritis and osteoarthritis includes the use of NSAIDs (traditional and selective inhibitors of cyclooxygenase COX-2), because they provide unmistakable and significant health benefits in the treatment of pain and inflammation. However, they are associated with an increased risk of serious gastrointestinal (GI) and cardiovascular (CV) adverse events. Both beneficial and adverse effects are due to the same mechanism of action, which is inhibition of COX-dependent prostanoids. Since CV and GI risk are related to drug exposure, a reduction in the administered dose is recommended. However, this strategy will not eliminate the hazard owing to a possible contribution of individual genetic background. Further studies will be necessary to develop genetic and/or biochemical markers predictive of the CV and GI risk of NSAIDs.
Patrignani et al. (Thu,) conducted a review in Rheumatoid arthritis and osteoarthritis. NSAIDs (traditional and selective COX-2 inhibitors) was evaluated. NSAIDs are associated with an increased risk of serious gastrointestinal and cardiovascular adverse events, which may be mitigated by dose reduction but require further study for predictive markers.