NDLI: Need to develop new nonsteroidal anti-inflammatory drug formulations.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	McCarberg, Bill Gibofsky, Allan
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: McCarberg B ( Neighborhood Healthcare, Escondido, California, USA. drknowpain@cox.net)
Abstract	BACKGROUND: In the management of pain, primary care physicians are often the first to diagnose and treat acute or chronic painful conditions. This places them in an important intersection to manage pain, in which safe and effective therapeutic options are paramount for their patients. For decades, NSAIDs have been routinely prescribed for relief of mild to moderate acute and chronic pain. Yet, safety and tolerability concerns associated with the use of this class of drugs continue to be an issue for patients and clinicians. OBJECTIVE: The objective of this review was to discuss the unmet medical needs of patients in the management of pain and inflammation, review the dose-dependent safety data associated with use of NSAIDs, and discuss the need to develop new NSAID formulations to improve safety and tolerability while maintaining efficacy. METHODS: We performed literature searches of the PubMed and Cochrane Library databases through December 2012 for articles in English that reported dose-dependent safety and tolerability data associated with use of NSAIDs. RESULTS: The risk of serious, dose-dependent adverse events involving the gastrointestinal tract, cardiovascular system, and kidneys is associated with use of NSAIDs. On the basis of these findings, the US Food and Drug Administration has requested that the package insert for all NSAIDs be revised to include a boxed warning highlighting the potential increased risk of cardiovascular events and the risk of serious, and potentially life-threatening, gastrointestinal tract bleeding. While using lower dosages of a particular NSAID may be associated with lower rates of adverse events, maintaining the clinical efficacy of standard NSAID dosages remains a challenge. CONCLUSIONS: There is a need to develop new and effective NSAID formulations to minimize the safety and tolerability concerns associated with currently available NSAIDs, yet maintain efficacy in management of inflammation and pain.
File Format	HTM / HTML
ISSN	01492918
Issue Number	9
Volume Number	34
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2012-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Anti-inflammatory Agents, Non-steroidal Therapeutic Use Inflammation Drug Therapy Pain Administration & Dosage Adverse Effects Dose-response Relationship, Drug Drug Design Drug Labeling Health Services Needs And Demand Humans Physician's Practice Patterns Primary Health Care Methods United States United States Food And Drug Administration Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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