NO-NSAID: A Novel Class of Anti-Inflammatory Drugs with Reduced Gastrointestinal and Renal Toxicity

Abstract

While non-steroidal anti-inflammatory drugs remain among the most widely used medications, their long-term use is associated with significant adverse effects, such as gastric ulceration, bleeding and perforation, as well as in increased risk of bleeding from pre-existing peptic ulcers. Several strategies have been taken to develop NSAIDs that are less toxic. Many such strategies have failed to make a significant impact on NSAID-related adverse effects. Two new approaches have been taken recently which show great promise. One is based on producing selective inhibitors of inducible cyclo-oxygenase that have been shown to spare the gastrointestinal tract. A second approach is the linking of standard NSAIDs to a nitric-oxide-releasing moiety. The studies so far conducted on this class of compounds have shown greatly reduced gastrointestinal toxicity. Here we report on the experimental evidence so far published on the good tolerability of this class of compounds in the stomach and kidney.