title: Combination therapy versus celecoxib, a single selective COX-2 agent, to reduce gastrointestinal toxicity in arthritic patients: patient and cost-effectiveness considerations.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for treating symptoms of rheumatologic diseases, such as osteoarthritis and rheumatoid arthritis. Knowing their side effects and the way to minimize them is a medical responsibility. To reduce NSAID-related risk, clinicians should choose a gastroprotective strategy. This may include coprescribing a traditional NSAID with a proton pump inhibitor or a high-dose histamine 2-receptor antagonist (H2RA), or using a cyclo-oxygenase (COX)-2 selective inhibitor or a COX-2 with a proton pump inhibitor. Assessing each patient's risk (cardiovascular and gastrointestinal) is a priority in order to decide the best intervention to minimize toxicity. In this article, we review some of the common interventions for reducing the gastrointestinal side effects of NSAIDs.
authors: Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors: Marina
authors: M
authors: Scolnik
authors: Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, Palo Alto, CA, USA.
authors: Gurkirpal
authors: G
authors: Singh
keywords: arthritis; celecoxib; cost-effectiveness; gastrointestinal toxicity; nonsteroidal anti-inflammatory drugs; osteoarthritis