La terapia con farmaci antiinfiammatori non-steroidei nel paziente reumatico: rischi e benefici.

Non steroidal anti-inflammatory drugs are by far the most widely prescribed drugs. This paper makes a critical analysis of the advantages and disadvantages of treatment with these drugs. A primary step is to identify the patient 'at risk', ruling out such therapy whenever the risks prove excessive. The use of preventive measures and monitoring must be as rationalized as possible. Among the greatest risks linked with the use of NSAIDs one must recall pharmacological interactions of both pharmacokinetic and pharmacodynamic nature, kidney side effects that are generally easy to predict and, above all, the stomach-related side effects. Today, NSAID(s)-induced gastropathy is certainly the most widely found complication both in terms of numbers and entity of the side effects. In clinical practice the most noteworthy effects linked to chronic assumption of NSAIDs are: a) significant risk of developing an ulcer, b) existence of a marked clinical-gastroscopic dissociation and c) appearance of s...