Benoxaprofen and its effect on serum alkaline phosphatase: a review

Benoxaprofen is a nonsteroidal anti-inflammatory agent with a novel spectrum of pharmacological activity including regulatory effects on monocytes. It significantly reduces the serum alkaline phosphatase in patients with osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. The reduction usually has been within the normal range, but sometimes there has been a change from an abnormal to a normal value. The possible significance of this observation and ways of examining it further are discussed in this review. The reduction may be an effect on osteoblasts secondary to an effect on osteoclasts, cells known to be derived from monocyte precursors. If so, benoxaprofen should be effective in Paget's disease of the bone and preliminary data suggest this may be so.