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Anti-inflammatory agents for the treatment of musculoskeletal pain and arthritis

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Abstract

Pain produced by musculoskeletal disorders commonly misconceived as having mechanical etiology often is caused by inflammatory mechanisms. Simple analgesics (ie, those that lack anti-inflammatory action) often are used to treat musculoskeletal pain when an anti-inflammatory analgesic may be more effective for the painful condition. This review addresses the anti-inflammatory agents available for the symptomatic management of common inflammatory musculoskeletal conditions including osteoarthritis, rheumatoid arthritis, and low back pain.

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erences and Recommended Reading

  1. Woolf AD, Pfleger B: Burden of major musculoskeletal conditions. Bull World Health Organ 2003, 81:646–656.

    PubMed  Google Scholar 

  2. Schaible HG, Ebersberger A, Von Banchet GS: Mechanisms of pain in arthritis. Ann N Y Acad Sci 2002, 966:343–354. The authors discussed the mechanisms of pain transmission in arthritis. This article contributed to the explanation of nociceptive transmission.

    Article  PubMed  CAS  Google Scholar 

  3. Scholz J, Woolf CJ: Can we conquer pain? Nat Neurosci 2002, 5(suppl):1062–1067. Good description of different types of pain. This review provided the figure of mechanisms of inflammatory pain.

    Article  PubMed  CAS  Google Scholar 

  4. Lozada CJ: Osteoarthritis. In Clinical Care in the Rheumatic Diseases. Edited by Robins LB, Hanna MT, DeHiratius RJ. Atlanta: Association of Rheumatology Health Professionals; 2001:113–126. This reference discusses clinical foundations, diagnosis, assessment, clinical interventions, and problem-focused management and provides clinical resources for common rheumatic conditions.

    Google Scholar 

  5. Gornisiewicz MM: Rheumatoid arthritis. In Clinical Care in the Rheumatic Diseases. Edited by Robins LB, Hanna MT, DeHiratius RJ. Atlanta: Association of Rheumatology Health Professionals; 2001:89–96.

    Google Scholar 

  6. Simon LS, Lipman AG, Jacox A, et al.: Guideline for the Management of Arthritis Pain in Osteoarthristis, Rheumatoid Arthritis, and Juvenile Chronic Arthritis, vol 2. Glenview, IL: American Pain Society; 2002. This reference provided treatment recommendations that are the best evidence available for the treatment of OA, RA, and JRA up to the time of publication. This reference was a guide to pharmacotherapy recommendation for this review.

    Google Scholar 

  7. Lo GH, LaValley M, McAlindon T, Felson DT: Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. JAMA 2003, 290:3115–3121.

    Article  PubMed  CAS  Google Scholar 

  8. Moulin DE: Systemic drug treatment for chronic musculoskeletal pain. Clin J Pain 2001, 17(suppl 4):S86-S93. Review of pharmacotherapy for the treatment of musculoskeletal pain. This reference is recommended for other agents not addressed in this article. This review contributed to the recommendation for NSAID use for musculoskeletal pain.

    Article  PubMed  CAS  Google Scholar 

  9. Chandrasekharan NV, Dai H, Roos KL, et al.: COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Natl Acad Sci U S A 2002, 99:13926–13931.

    Article  PubMed  CAS  Google Scholar 

  10. Bradley JD, Brandt KD, Katz BP, et al.: Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol 1992, 19:1950–1954.

    PubMed  CAS  Google Scholar 

  11. Geba GP, Weaver AL, Polis AB, et al.: Efficacy of rofecoxib, celecoxib, and acetaminophen in osteoarthritis of the knee: a randomized trial. JAMA 2002, 287:64–71.

    Article  PubMed  CAS  Google Scholar 

  12. Zimmerman HJ, Maddrey WC: Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure. Hepatology 1995, 22:767–773.

    Article  PubMed  CAS  Google Scholar 

  13. Brooks P, Emery P, Evans JF, et al.: Interpreting the clinical significance of the differential inhibition of cyclooxygenase-1 and cyclooxygenase-2. Rheumatology (Oxford) 1999, 38:779–788.

    Article  CAS  Google Scholar 

  14. Fernandez-Tome M, Kraemer L, Federman SC, et al.: COX-2-mediated PGD2 synthesis regulates phosphatidylcholine biosynthesis in rat renal papillary tissue. Biochem Pharmacol 2004, 67:245–254.

    Article  PubMed  CAS  Google Scholar 

  15. Bolli R, Shinmura K, Tang XL, et al.: Discovery of a new function of cyclooxygenase (COX)-2: COX-2 is a cardioprotective protein that alleviates ischemia/reperfusion injury and mediates the late phase of preconditioning. Cardiovasc Res 2002, 55:506–519.

    Article  PubMed  CAS  Google Scholar 

  16. Simon LS, Weaver AL, Graham DY, et al.: Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis: a randomized, controlled trial. JAMA 1999, 282:1921–1928.

    Article  PubMed  CAS  Google Scholar 

  17. Bensen WG, Fiechtner JJ, McMillen JI, et al.: Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized, controlled trial. Mayo Clin Proc 1999, 74:1095–1105.

    PubMed  CAS  Google Scholar 

  18. Emery P, Zeidler H, Kvien TK, et al.: Celecoxib versus diclofenac in long-term management of rheumatoid arthritis: randomized, double-blind comparison. Lancet 1999, 354:2106–2111.

    Article  PubMed  CAS  Google Scholar 

  19. McKenna F, Borenstein D, Wendt H, et al.: Celecoxib versus diclofenac in the management of osteoarthritis of the knee. Scand J Rheumatol 2001, 30:11–18.

    Article  PubMed  CAS  Google Scholar 

  20. Cannon GW, Caldwell JR, Holt P, et al.: Rofecoxib, a specific inhibitor of cyclooxygenase 2, with clinical efficacy comparable with that of diclofenac sodium: results of a 1-year, randomized, clinical trial in patients with osteoarthritis of the knee and hip. Rofecoxib Phase III Protocol 035 Study Group. Arthritis Rheum 2000, 43:978–987.

    Article  PubMed  CAS  Google Scholar 

  21. Day R, Morrison B, Luza A, et al.: A randomized trial of the efficacy and tolerability of the COX-2 inhibitor rofecoxib vs ibuprofen in patients with osteoarthritis. Rofecoxib/ Ibuprofen Comparator Study Group. Arch Intern Med 2000, 160:1781–1787.

    Article  PubMed  CAS  Google Scholar 

  22. Truitt KE, Sperling RS, Ettinger WH Jr, et al.: A multicenter, randomized, controlled trial to evaluate the safety profile, tolerability, and efficacy of rofecoxib in advanced elderly patients with osteoarthritis. Aging (Milano) 2001, 13:112–121.

    CAS  Google Scholar 

  23. Bombardier C, Laine L, Reicin A, et al.: Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 2000, 343:1520–1528.

    Article  PubMed  CAS  Google Scholar 

  24. Laufer S: Osteoarthritis therapy: Are there still unmet needs? Rheumatology (Oxford) 2004, 43(suppl 1):I9-I15.

    Article  CAS  Google Scholar 

  25. Miller D: Pharmacological interventions in the 21st century. In Clinical Care in the Rheumatic Diseases. Edited by Robins LB, Hanna MT, DeHiratius RJ. Atlanta: Association of Rheumatology Health Professionals; 2001:169–177.

    Google Scholar 

  26. Blyth T, Hunter JA, Stirling A: Pain relief in the rheumatoid knee after steroid injection: a single-blind comparison of hydrocortisone succinate and triamcinolone acetonide or hexacetonide. Br J Rheumatol 1994, 33:461–463.

    Article  PubMed  CAS  Google Scholar 

  27. Ghosh P, Guidolin D: Potential mechanism of action of intraarticular hyaluronan therapy in osteoarthritis: Are the effects molecular weight dependent? Semin Arthritis Rheum 2002, 32:10–37.

    Article  PubMed  CAS  Google Scholar 

  28. Felson DT, Anderson JJ: Hyaluronate sodium injections for osteoarthritis: hope, hype, and hard truths. Arch Intern Med 2002, 162:245–247.

    Article  PubMed  CAS  Google Scholar 

  29. Petrella RJ, DiSilvestro MD, Hildebrand C: Effects of hyaluronate sodium on pain and physical functioning in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2002, 162:292–298.

    Article  PubMed  CAS  Google Scholar 

  30. Cannella AC, O’Dell JR: Is there still a role for traditional diseasemodifying antirheumatic drugs (DMARDs) in rheumatoid arthritis? Curr Opin Rheumatol 2003, 15:185–192.

    Article  PubMed  Google Scholar 

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  1. University of Utah Health Sciences Center, Pharmacy Practice, 30 South 2000 East, Room 201, 84132, Salt Lake City, UT, USA

    Keri L. Fakata Pharm.D

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  1. Keri L. Fakata Pharm.D
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Fakata, K.L. Anti-inflammatory agents for the treatment of musculoskeletal pain and arthritis. Current Science Inc 8, 173–177 (2004). https://doi.org/10.1007/s11916-004-0048-2

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  • DOI: https://doi.org/10.1007/s11916-004-0048-2

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