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Posts Tagged ‘non steroidal anti inflammatory’

Ibuprofen

Ibuprofen

A new study released by the British Journal of Medicine reports that of all the non steroidal anti inflammatory drugs, Ibuprofen carries the highest risk of stroke.

The researchers used a sophisticated system to examine studies and trials that included over 116,000 patients.  Research was examined that compared NSAIDs with other NSAIDs and placebos.

This large meta-analysis discovered compelling cardiovascular problems in patients using prescription-strength NSAIDs.  Dr. Jeffrey Berger of NYU Medical Center in Manhattan said that a patient can take enough pills purchased over the counter to equal a prescription dose, so the findings “most likely” apply to over-the-counter NSAIDs as well as prescription-strength.

So check with your doctor.  Stop looking in your medicine cabinet for pain relief the next time your knee is hurting.  A knee brace is a safe, conservative treatment option for your osteoarthritis.  Nobody has ever died from a knee brace.



acetaminophen

acetaminophen-molecule

This blog post if one in a series of posts about the American Academy of Orthopedic Surgeons’ (AAOS) Full Guideline for the Treatment of Knee Osteoarthritis.

Recommendation 13 – The AAOS suggests that patients with osteoarthritis of the knee receive either acetaminophen or Non-steroidal anti inflammatory drugs (NSAIDs), unless there are contraindications to these drugs.

The research team looked at evidence suggesting that acetaminophen provides pain relief without a significant risk of toxicity to the patient.  The evidence further demonstrated that NSAIDs provide more pain relief than acetaminophen but with a greater risk of gastrointestinal complications.





This is a continuation of our series on the Osteoarthritis Research Society International (OARSI) recommendations for the management of hip and knee osteoarthritis published in the Journal of Osteoarthritis and Cartilage.

Non-Steroidal Anti-Inflammatory Drug

Recommendation XIV

Non Steroidal Anti Inflammatory (NSAIDs) drugs should be used at the lowest effective dose but their long-term use should be avoided.

  • There is evidence that NSAIDs can be effective in reducing pain in patients with osteoarthritis of the knee and hip.
  • Evidence exists that NSAIDs are superior to acetaminophen for pain relief in patients with OA.
  • There is a lot of evidence that NSAIDs are associated with more adverse effects than acetaminophen
  • NSAIDs can cause serious gastrointestinal problems, such as ulcers, perforations and bleeds
  • Prescribers and patients should continue to use NSAIDs at the lowest effective dose for the shortest duration to control symptoms
  • Prescribers should not switch between NSAIDs without careful consideration of the overall safety profile of the products and te patient’s individual risk factors, as well as the patient’s preferences.

The research team gave this osteoarthritis treatment option a Strength of Recommendation score of 93%.

W. Zhang Ph.D., Moskowitz M.D., et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. (2008) 16, 137-162.