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home > abstract > Rodriguez
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Rodriguez LAG.
Seminars in Arthritis and Rheumatism, 1997;26:S1:16-20.
This meta-analysis compared the
relative toxicity of 14 nonsteroidal anti-inflammatory
drugs (NSAIDs) from 12 studies with that of ibuprofen.
Ibuprofen had the lowest level of risk for GI toxicity.
This was followed by diclofenac. Acetylsalicylic acid,
sulindac, naproxen and indomethacin had an intermediate
level of risk. Ketoprofen, piroxicam and azapropazone
had the highest risk of GI toxicity. Five studies showed
that the level of risk was dose related. When ibuprofen
was administered at its full anti-inflammatory dose,
it had a similar risk profile to that of naproxen and
diclofenac. NSAIDs have greater variability in toxicity
than in efficacy. When prescribing NSAIDs as first-line
therapy, using one with a good safety profile, at the
lowest but most effective dose is recommended. Higher
doses or more toxic NSAIDs should only be used if the
situation demands it. Newer NSAIDs such as the selective
cyclooxygenase-2 inhibitors may have safer anti-inflammatory
effects.
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