Cyclooxygenase-2 inhibitors and nonsteroidal anti-inflammatory drugs in the management of arthritis.
The management of arthritis pain should be individualized to the needs and characteristics of the patient. The decision to use nonsteroidal anti-inflammatory drugs (NSAIDs), and in particular the cyclooxygenase-2 (COX-2) inhibitors, is multidimensional. The challenge is to achieve optimal pain relief at the minimum dose to minimize adverse effects. Whenever possible, NSAIDs should be given as monotherapies or in combinations at the lowest effective doses. The COX-2 inhibitors are a safe choice for most patients who are at low risk for a cardiovascular event. Individuals who are at risk for thromboses should not receive unopposed COX-2 inhibitors; COX-2 should be given in combination with low-dose aspirin which is expected to be cardioprotective in high-risk patients.
Kraus
Virginia Byers
VB
Division of Rheumatology, Department of Medicine, Box 3416, Duke University Medical Center, Durham, NC 27710, USA. vbk@acpub.duke.edu
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007596:Joints / Q000187:drug effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors