Quantifying the Impact of NSAID-associated Adverse Events

Am J Manag Care. 2013 Nov;19(14 Suppl):s267-72.

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used among patients experiencing many different types of pain, including inflammatory, acute pain (eg, injury, low back pain, headache, postoperative pain), and chronic pain (eg, rheumatoid arthritis, osteoarthritis). However, both traditional NSAIDs and second-generation NSAIDs (cyclooxygenase-2 inhibitors) can lead to very expensive and serious adverse events. Gastrointestinal, cardiovascular, and renal complications associated with NSAIDs have been shown to be dose-dependent. In 2005, to help minimize these risks, the US Food and Drug Administration issued a public health advisory stating that "NSAIDs should be administered at the lowest effective dose for the shortest duration consistent with individual patient treatment goals." This article reviews the undue clinical and economic burden associated with NSAID-related serious adverse events.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / economics*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy
  • Cost-Benefit Analysis
  • Cyclooxygenase 2 Inhibitors / adverse effects
  • Cyclooxygenase 2 Inhibitors / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug-Related Side Effects and Adverse Reactions / economics*
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Drug-Related Side Effects and Adverse Reactions / physiopathology
  • Female
  • Gastrointestinal Diseases / chemically induced
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / physiopathology
  • Humans
  • Kidney Diseases / chemically induced
  • Kidney Diseases / epidemiology
  • Kidney Diseases / physiopathology
  • Male
  • Managed Care Programs / economics*
  • Middle Aged
  • Pain / diagnosis
  • Pain / drug therapy*
  • Practice Guidelines as Topic
  • United States
  • United States Food and Drug Administration

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2 Inhibitors