The recent hospitalization of US Secretary of State Warren Christopher for a bleeding ulcer has focused attention on the use of non-steroidal anti-inflammatories to treat inflammatory conditions such as arthritis.
Complications from NSAIDs are the most prevalent serious drug-related toxicity in the USA. For example, gastrointestinal side effects such as nausea, dyspepsia and GI bleeding are common, and ulceration with occult bleeding and severe hemorrhage can also occur. The New York Times recently cited an (unnamed) medical journal as saying that NSAID complications lead to 41,000 hospitalizations and 3,300 deaths annually in the USA.
Upjohn's Ansaid (flurbiprofen), the drug used by Mr Christopher, is one of 25 such products approved in the USA - some 3.4% of the 2.2 billion prescriptions written annually are for NSAIDs and many more are bought over-the-counter for short-term relief. While the value of these agents in providing pain relief and reducing morbidity is without question, there is a growing feeling that aggressive marketing practices by pharmaceutical companies have made the drugs too popular, and that many patients could get adequate relief with fewer side effects and at less cost by using milder pain-killing drugs such as acetaminophen.
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