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The problems of using NSAIDs in the elderly.

G R Hughes1

  • 1Lupus/Arthritis Research Unit, Rayne Institute, St. Thomas' Hospital, London, United Kingdom.

Scandinavian Journal of Rheumatology. Supplement
|January 1, 1991
PubMed
Summary

Older women frequently use nonsteroidal anti-inflammatory drugs (NSAIDs). Despite risks like reduced kidney function, NSAIDs are generally well-tolerated in the elderly, with some agents posing higher gastrointestinal bleeding risks.

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Area of Science:

  • Geriatric Medicine
  • Pharmacology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used by individuals over 65, particularly women.
  • Concerns exist regarding NSAID toxicity in the elderly, including effects on glomerular filtration rate.
  • Despite potential risks, NSAIDs are often well-tolerated in this demographic.

Purpose of the Study:

  • To review the challenges and benefits of NSAID use in older patients.
  • To assess the comparative safety profiles of different NSAIDs in the elderly population.
  • To highlight NSAIDs as an advancement over aspirin for managing rheumatic diseases in seniors.

Main Methods:

  • Literature review of NSAID use and toxicity in patients over 65.
  • Analysis of adverse event reports, focusing on gastrointestinal bleeding.
  • Comparison of NSAID properties, including metabolic pathways (e.g., liver metabolism of ketoprofen).

Main Results:

  • NSAIDs are extensively used by women over 65.
  • While risks like reduced glomerular filtration rate are known, overall tolerance in the elderly is surprisingly good.
  • Certain NSAIDs exhibit a higher propensity for gastrointestinal bleeding, especially in older females.

Conclusions:

  • NSAIDs represent a significant improvement over aspirin for managing rheumatic conditions in the elderly.
  • Ketoprofen, due to liver metabolism, may offer advantages in elderly patients compared to other NSAIDs.
  • Careful consideration of individual NSAID risks, particularly gastrointestinal bleeding in older women, is essential.

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