Interní Med. 2008; 10(3): 121-125
Current view on NSAID therapy
- Revmatologický ústav, Praha
Nonsteroidal anti-inflammatory drugs (NSAID) belong to the most frequently used medications. Their use is however accompanied by relatively frequent occurrence of adverse gastrointestinal events. Coxibs were developed with the goal to decrease the risk of adverse events in gastrointestinal tract; it was discovered later, that they might increase the occurrence of cardiovascular events. Recently it was discovered that the cardiotoxic effect is in a various extent a property of all NSAIDs, including e.g. diclofenac, ibuprofen etc. Concomitant use of acetylsalicylic acid (ATA) reduces the risk of cardiovascular events, if used together with rofecoxib, celecoxib, sulindac, meloxicam and indomethacin, however its effect may be decreased by concomitant use of ibuprofen. The benefit of coxibs in gastrointestinal tract in comparison to traditional NSAIDs is preserved even in the case of current use of ATA. It is necessary to asses individually the ratio of gastrointestinal and cardiovascular risk, take into account also other risk factors and choose an optimal therapeutic approach.
Keywords: with nonsteroidal anti-inflammatory drugs, coxibs, cardiovascular events, gastrointestinal toxicity
Published: May 1, 2008 Show citation
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