TRC: NSAIDs for RA

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs)

Most drugs of the group of non-steroidal anti-inflammatory drugs (NSAIDs), or prostaglandin synthesis inhibitors are non-specific COX inhibitors. These drugs inhibit both isoforms of the cyclo-oxygenase enzyme: COX-1 and COX-2. They inhibit thus the conversion of arachidonic acid into prostaglandins. These drugs are used to inhibit pain stimuli (decrease pain intensity) and to lower inflammatory reactions and fever.

The non-specific nature of these drugs is responsible for most of the side effects. Because conventional NSAIDs also inhibit COX-1, general homeostatic functions like protection of the gastrointestinal tract, renal perfusion and platelet function are disturbed. Consequently, peptic ulcus can develop and/or kidney function can diminish. Since both, COX-1 and COX-2 influence platelet function in opposite way, the use of non-specific COX inhibitors usually does not result in side effects such as arterial thrombosis etc.

See also prostaglandin synthesis for more information on the physiological role of COX-enzymes.

Examples of NSAIDs are aspirin, diclofenac, ibuprofen, naproxen, indomethacin, and piroxicam.