Rheumatology, Vol 38, 4-10, Copyright © 1999 by British Society for Rheumatology
KD Rainsford
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely
used drugs and their use is frequently associated with severe or even
serious adverse events, which increase morbidity and mortality. The
increase of toxic effects, primarily of the digestive system, due to
treatment with NSAIDs, underlines a need for safer NSAIDs. Nimesulide
(4-nitro-2-phenoxymethanesulphonanilide) is a chemically unique
anti-inflammatory agent in that it has a higher pKa (6.5) than conventional
acidic NSAIDs and it is one of the newer class of NSAIDs that are selective
for cyclooxygenase-2. Nimesulide also has additional activities, among them
effects on production/action of oxy-radicals and other components of
neutrophil activation that may contribute to the spectrum of its
anti-inflammatory activity as well as potentially reducing the likelihood
of gastrointestinal ulcerogenicity. An analysis was performed of the safety
data of nimesulide collected in clinical studies and from those reported
spontaneously worldwide in the post- marketing phase. The results show that
nimesulide is associated with a relatively low occurrence of adverse drug
reactions especially in the gastrointestinal tract while those in the liver
are within or below the general incidence with other NSAIDs.
REVIEWS
Relationship of nimesulide safety to its pharmacokinetics: assessment of adverse reactions
Biomedical Research Centre, Sheffield Hallam University, UK.
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