Zusammenfassung
Die Pharmakotherapie muskuloskelettaler Schmerzen besitzt in den westlichen Industrieländern einen hohen Stellenwert. Die vorliegende Übersicht konzentriert sich auf den Einsatz saurer (nicht-steroidale Antiphlogistika) und nicht-saurer [Paracetamol, selektive Zyklooxygenase- (COX-)2-Hemmer] antipyretischer Analgetika in der Therapie muskuloskelettaler Schmerzzustände. Schwerpunkt der Darstellung sind die unterschiedlichen kinetischen Eigenschaften und unerwünschten Wirkungen dieser Substanzen.
Abstract
The pharmacotherapy of musculoskeletal pain remains of high importance in Western countries. The present review concentrates on the use of acidic (nonsteroidal anti-inflammatory drugs) and nonacidic (paracetamol, selective cyclooxygenase-2 inhibitors) antipyretic analgesics in the therapy of musculoskeletal pain disorders with particular emphasis on the diverse pharmacokinetic properties and unwanted side effects of these substances.
Literatur
Ahmadi S, Lippross S, Neuhuber WL, Zeilhofer HU (2002) PGE2 selectively blocks inhibitory glycinergic neurotransmission onto rat superficial dorsal horn neurons. Nat Neurosci 5: 34–40
Akopian AN, Sivilotti L, Wood JN (1996) A tetrodotoxin-resistant voltage-gated sodium channel expressed by sensory neurons. Nature 379: 257–262
Baba H, Kohno T, Moore KA, Woolf CJ (2001) Direct activation of rat spinal dorsal horn neurons by prostaglandin E2. J Neurosci 21: 1750–1756
Beiche F, Scheuerer S, Brune K et al. (1996) Upregulation of cyclooxygenase-2 mRNA in the rat spinal cord following peripheral inflammation. FEBS Lett 390: 165–169
Bombardier C, Laine L, Reicin A et al. (2000) Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 343: 1520–1528
Boutaud O, Aronoff DM, Richardson JH et al. (2002) Determinants of the cellular specificity of acetaminophen as an inhibitor of prostaglandin H2 synthases. Proc Natl Acad Sci USA 99: 7130–7135
Brandt K (2003) Paracetamol in the treatment of osteoarthritis pain. Drugs 63(2): 23–41
Bresalier RS, Sandler RS, Quan H et al. (2005) Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352: 1092–1102
Brune K, Hinz B (2004) Selective cyclooxygenase-2 inhibitors: similarities and differences. Scand J Rheumatol 33: 1–6
Brune K, Lanz R (1985) Pharmacokinetics of non-steroidal anti-inflammatory drugs. In: Bonta IL, Bray MA, Parnham MJ (eds) Handbook of inflammation, Vol 5, The Pharmacology of Inflammation. Elsevier, Amsterdam, pp 413–449
Cannon CP, Curtis SP, FritzGerald GA et al. for the MEDAL Steering Commitee (2006) Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the multinational etoricoxib and diclofenac arthritis long-term (MEDAL) programme: a randomided comparison. Lancet, published anline Nov 13, 2006
Catella-Lawson F, McAdam B, Morrison BW et al. (1999) Effects of specific inhibition of cyclooxygenase-2 on sodium balance, hemodynamics, and vasoactive eicosanoids. J Pharmacol Exp Ther 289: 735–741
Catella-Lawson F, Reilly MP, Kapoor SC et al. (2001) Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 345: 1809–1817
Caterina MJ, Leffler A, Malmberg AB et al. (2000) Impaired nociception and pain sensation in mice lacking the capsaicin receptor. Science 288: 306–313
Chandrasekharan NV, Dai H, Roos KL et al. (2002) COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Natl Acad Sci USA 99: 13926–13931
Cheng Y, Austin SC, Rocca B et al. (2002) Role of prostacyclin in the cardiovascular response to thromboxane A2. Science 296: 539–541
Davis JB, Gray J, Gunthorpe MJ et al. (2000) Vanilloid receptor-1 is essential for inflammatory thermal hyperalgesia. Nature 11(405): 183–187
Dinchuk JE, Liu RQ, Trzaskos JM (2003) COX-3: in the wrong frame in mind. Immunol Lett 86: 121
EMEA (2005) Press release: European Medicines Agency concludes action on COX-2 inhibitors. London, 27 June 2005. Doc. Ref. EMEA/207766/2005
EMEA (2005) Press release: European Medicines Agency update on non-selective NSAIDs. London, 17 October 2005. Doc. Ref. EMEA/298964/2005
EMEA (2005) Key elements fort he summaries of product characteristics of non-selective NSAIDs adopted by the CHMP during its meeting in October 2005. Doc. Ref EMEA/CHMP/343456/2005
EMEA (2006) European Medicines Agency review concludes positive benefit-risk balance for non-selective NSAIDs. Doc. Ref EMEA/413136/2006
Empfehlungen zur Therapie von Fettstoffwechselstörungen (1999) Arzneiverordnung in der Praxis. Sonderheft Therapieempfehlungen der Arzneimittelkommission der Deutschen Ärzteschaft, 2. Aufl. AkdÄ, Berlin
Farkouh ME, Kirshner H, Harrington RA et al. (2004) Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial. Lancet 364: 675–684
FDA (2005) FDA News: FDA announces series of changes to the class of marketed non-steroidal anti-inflammatory drugs (NSAID). http://www.fda.gov/bbs/topics/news/2005/NEW01171.html
FDA (2006) FDA Science Paper: Concomitant use of ibuprofen and aspirin: potential for attenuation of the antiplatelet effect of aspirin. 9/8/2006 http://www.fda.gov/cder/drug/infopage/ibuprofen/default.htm
Forman JP, Stampfer MJ, Curhan GC (2005) Non-narcotic analgesic dose and risk of incident hypertension in US women. Hypertension 46: 500–507
Gavett SH, Madison SL, Chulada PC et al. (1999) Allergic lung responses are increased in prostaglandin H synthase-deficient mice. J Clin Invest 104: 721–732
Geba GP, Weaver AL, Polis AB et al. (VACT) Group (2002) Efficacy of rofecoxib, celecoxib, and acetaminophen in osteoarthritis of the knee: a randomized trial. JAMA 287: 64–71
Giannitsis E (2005) Rationale for testing the cardiovascular risk for patients with COX-2 inhibitors on the basis of biomarker NT-proBNP. Clin Lab 51: 63–83
Gyllfors P, Bochenek G, Overholt J et al. (2003) Biochemical and clinical evidence that aspirin-intolerant asthmatic subjects tolerate the cyclooxygenase 2-selective analgetic drug celecoxib. J Allergy Clin Immunol 111: 1116–1121
Hansson L, Zanchetti A, Carruthers SG et al. (1998) Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. HOT Study Group. Lancet 351: 1755–1762
Harvey RJ, Depner UB, Wassle H et al. (2004) GlyR α3: an essential target for spinal PGE2-mediated inflammatory pain sensitization. Science 304: 884–887
Hernandes-Diaz S, Varas-Lorenzo C, Garcia Rodriguez LA (2006) Non-steroidal antiinflammatory drugs and the risk of acute myocardial infarction. Basic Clin Pharmacol Toxicol 98: 266–274
Hinz B, Brune K (2002) Cyclooxygenase-2 – Ten years later. J Pharmacol Exp Ther 300: 367–375
Hinz B, Brune K (2004) Non-steroidal anti-inflammatory drugs – old and new. In: Isenberg DH, Maddison PJ, Woo P, Glass D, Breedveld FC (eds) Oxford textbook of rheumatology, 3rd edn. Oxford University Press, Oxford, pp 442–450
Hinz B, Dormann H, Brune K (2006) More pronounced inhibition of cyclooxygenase-2, increase in blood pressure, and reduction of heart rate by treatment with diclofenac compared with celecoxib and rofecoxib. Arthritis Rheum 54: 282–291
Hippisley-Cox J, Coupland C (2005) Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ 330: 1366
Kearney PM, Baigent C, Godwin J et al. (2006) Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomided trials. BMJ 332: 1302–1308
Muth-Selbach US, Tegeder I, Brune K, Geisslinger G (1999) Acetaminophen inhibits spinal prostaglandin E2 release after peripheral noxious stimulation. Anesthesiology 91: 231–239
NIH (2004) NIH News. Use of non-steroidal anti-inflammatory drugs suspended in large Alzheimer’s disease prevention trial. http://www.nih.gov/news/pr/dec2004/od-20.htm
Nussmeier NA, Whelton AA, Brown MT et al. (2005) Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery. N Engl J Med 352: 1081–1091
Ott E, Nussmeier NA, Duke PC et al. (2003) Efficacy and safety of the cyclooxygenase 2 inhibitors parecoxib and valdecoxib in patients undergoing coronary artery bypass surgery. J Thorac Cardiovasc Surg 125: 1481–1492
Pincus T, Koch G, Lei H et al. (2004) Patient preference for placebo, Acetaminophen (paracetamol) or Celecoxib efficacy studies (PACES): two randomised, double blind, placebo controlled, crossover clinical trials in patients with knee or hip osteoarthritis. Ann Rheum Dis 63: 931–939
Rabausch K, Bretschneider E, Sarbia M et al. (2005) Regulation of thrombomodulin expression in human vascular smooth muscle cells by COX-2-derived prostaglandins. Circ Res 96: 1–6
Reinold H, Ahmadi S, Depner UB et al. (2005) Spinal inflammatory hyperalgesia is mediated by prostaglandin E receptors of the EP2 subtype. J Clin Invest 115: 673–679
Sanchez-Borges M, Caballero-Fonseca F, Capriles-Hulett A (2005) Safety of etoricoxib, a new cyclooxygenase 2 inhibitor, in patients with nonsteroidal anti-inflammatory drug-induced urticaria and angioedema. Ann Allergy Asthma Immunol 95: 154–158
Schnitzer TJ (2002) Update of ACR guidelines for osteoarthritis: role of the coxibs. J Pain Symptom Manage 23 [4 Suppl]: 24–30
Schnitzer TJ, Burmester GR, Mysler E et al. (2004) Comparison of lumiracoxib with naproxen and ibuprofen in the therapeutic arthritis research and gastrointestinal event trial (TARGET), reduction in ulcer complications: randomised controlled trial. Lancet 364: 665–674
Schwab JM, Beiter T, Linder JU et al. (2003) COX-3 – a virtual pain target in humans? FASEB J 17: 2174–2175
Schwartz JI, Vandormael K, Malice MP et al. (2002) Comparison of rofecoxib, celecoxib, and naproxen on renal function in elderly subjects receiving a normal-salt diet. Clin Pharmacol Ther 72: 50–61
Seeff LB, Cuccherini BA, Zimmerman HJ et al. (1986) Paracetamol hepatotoxicity in alcoholics. Ann Intern Med 104: 399–404
Silverstein FE, Faich G, Goldstein JL et al. (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. J Am Med Assoc 284: 1247–1255
Singh G, Miller JD, Huse DM et al. (2003) Consequences of increased systolic blood pressure in patients with osteoarthritis and rheumatoid arthritis. J Rheumatol 30: 714–719
Singh G, Mithal A, Triadafilopoulos G (2005) Both selective COX-2 inhibitors and non-selective NSAIDs increase the risk of acute myocardial infarction in patients with arthritis: selectivity is with the patient, not with the drug class. Annual European Congress of Rheumatology, Vienna, 8–11 June 2005; Abstract OP0091
Solomon SD, McMurray JJ, Pfeffer MA et al. (2005) Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med 352: 1071–1080
Szczeklik A, Nizankowska E, Bochenek G et al. (2001) Safety of a specific COX-2 inhibitor in aspirin-induced asthma. Clin Exp Allergy 31: 219–225
Vane JR (1971) Inhibition of prostaglandin synthesis as a mechanism of action of aspirin-like drugs. Nature New Biol 231: 232–235
Zhang W, Jones A, Doherty M (2004) Does paracetamol (acetaminophen) reduce the pain of osteoarthritis? A meta-analysis of randomised controlled trials. Ann Rheum Dis 63: 901–907
Interessenkonflikt
K. B. hat sämtliche auf dem Gebiet der Analgetika/Antirheumatika forschenden Firmen beraten.
Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hinz, B., Brune, K. Schmerztherapie mit antipyretischen Analgetika. Orthopäde 36, 23–31 (2007). https://doi.org/10.1007/s00132-006-1024-9
Issue Date:
DOI: https://doi.org/10.1007/s00132-006-1024-9