Advances in rheumatology: coxibs and beyond.
Arthritis is a growing health concern in the US with approximately 70 million Americans currently affected. This figure will inevitably rise as the population ages. The pain and decreased mobility associated with arthritis have a significant impact on quality of life and because patients with arthritis are less active than the general population, they are at risk of additional conditions such as obesity, heart disease, diabetes, and hypertension. There are currently no disease modifying osteoarthritis (OA) drugs available; therefore anti-inflammatory, and/or analgesic medications such as acetaminophen and NSAIDs and simple analgesics form the mainstay of treatment. Coxibs may be preferred to traditional NSAIDs because of their improved gastrointestinal (GI ) safety and tolerability profile. The use of topical agents may also be beneficial in some patients. In rheumatoid arthritis (RA) where disease modifying drugs (DMARDs) are available, anti-inflammatory agents such as NSAIDs and coxibs are used as adjuncts to disease modifying therapy. However, patients with RA are at increased risk of NSAID-related GI injury, particularly if they are also on corticosteroid medication. Pharmacological treatment of both RA and OA should be combined with appropriate nonpharmacological modalities such as patient education, exercise programs, and joint motion and strengthening exercises. Such activities may delay joint degradation and help maintain physical function.
Kuritzky
Louis
L
Department of Community Health and Family Medicine, University of Florida, Gainesville, FL 32608, USA.
Weaver
Arthur
A
D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy*; D010166:Palliative Care; D012219:Rheumatology / Q000639:trends*
D016861:Cyclooxygenase Inhibitors