Monitoring of anti-inflammatory drugs

Advances in analytic technology have allowed clinical laboratories to accurately measure plasma levels of NSAIDs. With the exception of salicylate, however, there is no relationship, or only a weak one, between plasma NSAID levels and clinical responses. Therefore, therapeutic drug monitoring of NSAIDs other than salicylate is of little value to clinicians in their management of patients with rheumatoid arthritis. On occasion, however, it may be helpful to monitor specific patients suspected of noncompliance by measuring plasma drug levels. Routine therapeutic drug monitoring of these NSAIDs must await further work on the refinement of quantitating clinical response and the possible relationship between free drug level and drug effects.