According to the researchers, controversy now exists as to the safest and most efficacious way of treating osteoarthritis, particularly with respect to use of NSAIDs, both non-selective and selective (so-called COX-2 selective agents or coxibs).
Adverse reactions related to the gastrointestinal tract, particularly with the non-selective NSAIDs, have been described; more recently, concerns have been expressed related to the cardiovascular system with both groups of agents.
The researchers say that a recent scientific statement from the American Heart Association (AHA) made non-evidence-based recommendations that high-dose aspirin be administered alone as a first line therapy for patients with chronic pain and arthritis.
Dr Roland Moskowitz, professor of medicine at Case Western Reserve University/University Hospitals of Cleveland, commented: “Careful review of the pros and cons of using these agents, and the situations in which they are most safely and effectively used, is required to help us understand how best to take advantage of their availability.”