What do you think about the use of the NSAIDS for treatment of the rheumatoid ar
March 21, 2008 12:40am CST
It is a well known fact that the long term side effects of using the NSAIDS are immense but still they are having wide spread use in such patients …. The readers are requested to give their valuable ifomation tat they know regarding this matter. NSAIDs are important for the symptomatic relief they provide to RA patients; however, they play only a minor role in altering the underlying disease process. Therefore, NSAIDs should rarely, if ever, be used to treat RA without the concomitant use of DMARDs. Many clinicians waste valuable time switching from one NSAID to another before starting DMARD therapy. Much has been written about the gastrointestinal toxicity of NSAIDs, and these concerns are particularly relevant to RA patients, who often have significant risk factors including age and concomitant steroid use. Therefore, cyclooxygenase-2 (COX2)-selective agents have been a popular choice for patients with RA. The recent evidence linking these agents to increased cardiovascular toxicity has been particularly troubling for patients with RA, who are already at high risk for myocardial infarction. Therefore, if COX2-selective agents are used, they should be kept at a low dose. Consideration should be given to low-dose aspirin prophylaxis in RA, but this may increase the gastrointestinal toxicity of NSAIDs. The use of concomitant misoprostol or proton pump inhibitors should be considered in all patients with RA who are taking NSAIDs. Additionally, the potential for NSAIDs to decrease renal blood flow and to increase blood pressure should be kept in mind.