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Treating Osteoarthritis With Cox II Inhibitors And NSAIDs
16 Aug 2007
As edited by Joint-Pain-Forum.com
In an Editorial, to be published in the international journal Osteoarthritis and Cartilage (http://intl.elsevierhealth.com/journals/joca/),
published by Elsevier, a panel of arthritis research experts has
recommended that coxibs and nonsteroidal anti-inflammatory drugs
(NSAIDs) must remain a significant part of the tool kit used in
treating osteoarthritis (OA). The Editorial summarizes the outcomes of
an international workshop organized by the Osteoarthritis Research
Society International (OARSI) and the International COX-2 Study Group.
The authors urge that an evidence-based approach must be taken when
making recommendations to patients.
OA, the most common form of arthritis, is a major medical
problem. It has been estimated that over 20 million Americans are
afflicted with OA, and that number will rise to 40 million by the year
2020. Controversy now exists as to the safest and most efficacious way
of treating the disease, 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.
A recent scientific statement from the American Heart
Association (AHA) made recommendations with regard to the treatment of
OA.1 A number of these recommendations are challenged in the Editorial2
in Osteoarthritis and Cartilage, with particular concern about their
impact on appropriate use of these agents.
The Editorial questions the recommendation made in the AHA
statement which described a stepped care approach to pharmacologic
therapy for musculoskeletal diseases. The Editorial strongly recommends
that several aspects of the AHA statement be reconsidered. For example,
it urges that the AHA withdraw their 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 W. Moskowitz, Professor of Medicine at Case Western
Reserve University/University Hospitals of Cleveland, lead author of
the Editorial comments, "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".
The input by the OARSI/COX-2 International Study Group
provides evidence-based background and guidance that will be of help to
physicians, and to patients, in the use of these important commonly
Article adapted by www.Joint-Pain-Forum.com from original press release.
Please see the article for additional information including author affiliations, financial disclosures, funding and support etc.
1. E.M. Antman, J.S. Bennett, A. Daugherty, C. Furberg, H. Roberts,
K.A. Taubert, Use of nonsteroidal antiinflammatory drugs. An update for
clinicians: a scientific statement from the American Heart Association,
2. R.W. Moskowitz, S. Abramson, F Berenbaum, L.S.Simon, M. Hochberg,
Coxibs and NSAIDS -- Is the air any clearer? Perspectives from the
OARSI international COX-2 workshop 2007, Osteoarthritis and Cartilage. 2007;15:849-856.
The Osteoarthritis Research Society International (OARSI) is a
non-profit scientific professional organization that promotes and
encourages fundamental and applied research in osteoarthritis. It is
the only worldwide organization with the sole focus on OA
(www.oarsi.org). Osteoarthritis and Cartilage
is an international journal, owned by OARSI, and published on their
behalf by Elsevier Ltd. The Journal is highly cited, being the top
ranked orthopedics journal by impact factor (according to Thomson
Scientific's Journal Citation Reports -- 2007). It is also widely read
-- over 186,000 full-text papers from the Journal were downloaded via
ScienceDirect in 2006.
Elsevier is a world-leading publisher of scientific, technical
and medical information products and services. Working in partnership
with the global science and health communities, Elsevier's 7,000
employees in over 70 offices worldwide publish more than 2,000 journals
and 1,900 new books per year, in addition to offering a suite of
innovative electronic products, such as ScienceDirect (http://www.sciencedirect.com/), MD Consult (http://www.mdconsult.com/), Scopus (http://www.info.scopus.com/), bibliographic databases, and online reference works.
is a global business headquartered in Amsterdam, The Netherlands and
has offices worldwide. Elsevier is part of Reed Elsevier Group plc (http://www.reedelsevier.com/),
a world-leading publisher and information provider. Operating in the
science and medical, legal, education and business-to-business sectors,
Reed Elsevier provides high-quality and flexible information solutions
to users, with increasing emphasis on the Internet as a means of
delivery. Reed Elsevier's ticker symbols are REN (Euronext Amsterdam),
REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
Source: Ian Salusbury
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