Using coxibs and NSAIDs to treat oste...( Mt Laurel NJ 13 August 2007 - In an...),Health

Mt Laurel, NJ 13 August 2007 - 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, held 2425 March 2007. 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 reconsi
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