title: Update on the use of analgesics versus nonsteroidal anti-inflammatory drugs in rheumatic disorders: risks and benefits.
abstract: OBJECTIVE
  In the last 2 years, there have been numerous publications on the safety of nonsteroidal anti-inflammatory drugs and cyclo-oxygenase-2 inhibitors. An evaluation of the potential risks and benefits of other analgesics has also followed. In this time of greater analysis of analgesic use, this review seeks to present the most recent evidence.
  
  
  RESULTS
  Concerns of potential hepatotoxicity of therapeutic doses of paracetamol have been highlighted in the last 18 months. The efficacy and risks of long-term opioid use have also been reevaluated. The debate over nonsteroidal anti-inflammatory drug and cyclo-oxygenase-2 inhibitor safety continues.
  
  
  CONCLUSIONS
  Recent evidence has prompted a reassessment of the safety of paracetamol in certain groups of patients. Further clarification on the risks of nonsteroidal anti-inflammatory drug and cyclo-oxygenase-2 therapy for individuals is covered. Their use, increased cardiovascular risk and long-term implications need to be evaluated.
authors.affiliation: Centre for Rheumatic Diseases, Glasgow Royal Infirmary, Glasgow, UK. gayle.mckellar@northglasgow.scot.nhs.uk
authors.forename: Gayle
authors.initials: G
authors.lastname: McKellar
authors.forename: Rajan
authors.initials: R
authors.lastname: Madhok
authors.forename: Gurkirpal
authors.initials: G
authors.lastname: Singh
mesh_terms: D000700:Analgesics / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D012216:Rheumatic Diseases / Q000150:complications / Q000188:drug therapy*; D018570:Risk Assessment
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents