[Non-steroidal anti-inflammatory drugs : clarification for the practitioner].

Area of Science:

• Pharmacology and Therapeutics
• Drug Safety and Adverse Event Monitoring

Background:

• Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for pain and inflammation.
• Their use is often limited by a significant side effect profile, including gastrointestinal, renal, and cardiovascular issues.
• Selective cyclooxygenase-2 (COX-2) inhibitors were developed as an alternative to non-selective NSAIDs, offering improved digestive tolerance.

Purpose of the Study:

• To review the fundamental principles of NSAID action.
• To provide a comprehensive overview of the main side effects associated with NSAID use.
• To discuss the safety profile of selective COX-2 inhibitors in comparison to traditional NSAIDs.

Main Methods:

• Literature review of basic principles of NSAIDs.
• Analysis of reported adverse effects, focusing on gastrointestinal, renal, and cardiovascular events.
• Comparative assessment of safety profiles between non-selective NSAIDs and selective COX-2 inhibitors.

Main Results:

• Non-selective NSAIDs are associated with significant gastrointestinal risks.
• Selective COX-2 inhibitors demonstrate improved gastrointestinal safety but have been linked to increased cardiovascular events.
• Adverse effects across various organ systems have been increasingly characterized for both NSAID classes.

Conclusions:

• NSAIDs, including selective COX-2 inhibitors, require careful consideration of their risk-benefit profile.
• Understanding the specific side effects of different NSAID classes is crucial for safe clinical practice.
• Ongoing pharmacovigilance is essential to fully characterize and manage NSAID-associated risks.