McKellar Gayle, Madhok Rajan, Singh Gurkirpal
Center for Rheumatic Diseases, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF, UK.
Curr Pain Headache Rep. 2007 Dec;11(6):423-7. doi: 10.1007/s11916-007-0228-y.
Patients with rheumatoid arthritis and osteoarthritis have relied upon NSAIDs as a cornerstone of their analgesic regime for decades. The choice of anti-inflammatory agents broadened for this group of patients when the selective inhibitors of cyclooxygenase-2 enzyme were developed. Much has been published in the past few years regarding the superior gastrointestinal safety of this class of drugs when compared with traditional NSAIDs. Their triumphant debut was swiftly followed by the emergence of data detailing their associated increased serious cardiovascular risks. This also led to a reevaluation of data concerning more traditional NSAIDs, and surprisingly, a similar trend was seen. The US Food and Drug Administration has recommended that both classes of drugs carry a black box warning with regard to gastrointestinal and cardiovascular risks.
