Statement | Category of evidence |
---|---|
NSAIDs are effective drugs in relieving pain and immobility associated with osteoarthritis. COX-2 selective agents are equally effective. | A* |
NSAIDs and COX-2 inhibitors vary in their potential gastrointestinal, liver and cardio-renal toxicity. This risk varies between individual treatments within both groups and is increased with dose and duration of treatment | A* |
COX-2 selective agents are associated with a significantly lower gastrointestinal toxicity (PUBs and dyspepsia) compared to non-selective NSAIDs. Co-prescribing of aspirin reduces this advantage. | A* |
PPI should always be considered with a non-selective NSAID and with a COX-2 agent in higher GI risk patients. | C†|