20 years' experience with ketoprofen

Ketoprofen has emerged as a potent nonsteroidal anti-inflammatory drug. Its efficacy in the treatment of conditions such as rheumatoid arthritis and osteoarthritis has been demonstrated throughout nearly 20 years of clinical use. It has also been shown to be an effective analgesic. In comparative studies, ketoprofen appears to be at least as effective as other anti-inflammatory and analgesic agents. Because of its short half-life (approximately 1.5 hours) no dosage adjustment appears to be necessary in elderly patients unless there is concomitant renal insufficiency. Although rapidly eliminated from plasma, elimination from synovial fluid is delayed, so therapeutic concentrations can be maintained in affected joints without necessitating frequent administration. The side effects of ketoprofen are similar to those of all NSAIDs, gastrointestinal disturbances being the most frequent. Evidence for the adverse effects of NSAIDs on cartilage is still limited. Drug interactions are similar to those of all NSAIDs, antacids, methotrexate and probenecid being particularly important. Ketoprofen is available in a wide range of formulations, each designed to provide appropriate therapy in specific clinical situations: oral capsules for short term therapy; sustained release forms for chronic therapy and once-daily administration; suppositories to avoid possible gastrointestinal disturbances in susceptible patients; intramuscular preparations for rapid action; and a gel formulation for topical treatment. In the future, research should determine whether ketoprofen and other NSAIDs have any disease-modifying effects on inflammatory conditions in addition to providing symptomatic relief.