An overview of nonsteroidal antiinflammatory agents (NSAIA)

Since the rediscovery of willow bark extract (salicin) in 1763, there has been a continuing effort to improve efficacy and reduce the side effects of antiinflammatory agents through chemical modification and innovation. The second-generation NSAIA's, phenylbutazone and indomethacin, provided clear support for the idea that these objectives were obtainable. The success of steroid programs in enhancing potency and modifying side effects, coupled with the development of effective screening techniques for identifying antiinflammatory activity, stimulated an enormous effort to develop new NSAIA's. The products of this effort are now coming to the clinic. Although less successful than the steroid program in enhancing potency, the effort has succeeded in changing and reducing side effects. As a result, the clinician has a greater choice of agents for dealing with individual patient variability and achieving greater patient acceptance.