Correlation plasma levels, NSAID and therapeutic response.

Area of Science:

• Pharmacology
• Clinical Chemistry

Background:

• Regular monitoring of nonsteroidal anti-inflammatory drug (NSAID) plasma levels is suggested for managing side effects and ensuring patient compliance.
• Establishing a link between drug concentration and clinical outcomes requires specific prerequisites, often unmet for NSAIDs.

Purpose of the Study:

• To explore the utility of regular NSAID plasma level monitoring.
• To assess the correlation between NSAID plasma concentrations and their therapeutic and adverse effects.

Main Methods:

• Review of existing literature on NSAID pharmacokinetics and pharmacodynamics.
• Analysis of studies correlating drug plasma levels with clinical effects and side effects.

Main Results:

• Evidence for a strong correlation between NSAID plasma levels and clinical effects is scarce.
• The best correlations were observed with salicylates, with established therapeutic ranges for rheumatoid arthritis.
• Correlations for side effects like tinnitus and salicylism were also noted, but with significant individual variability and overlap between therapeutic and toxic levels.

Conclusions:

• NSAID plasma level monitoring has potential benefits but lacks robust evidence of correlation with clinical outcomes for most NSAIDs.
• Salicylates show the most promising correlation, but individual variations persist.
• Further research is needed to establish reliable monitoring strategies for NSAIDs in managing rheumatic diseases.