POSSIBILITIES TO USE NON-STEROID ANTI-INLAMMATORY DRUGS IN CLINICAL PRACTICE: FOCUS ON NIMESULIDE

• Published in: Medical Council no. 17; pp. 124 - 131
• Main Authors: Olyunin, Y. A., Nikishina, N. Y.
• Format: Journal Article
• Language: English; Russian
• Published: Remedium Group LLC 01.11.2017
• Subjects: cyclooxygenase; nimesulide; osteoarthritis; pain in the lower back; rheumatoid arthritis
• ISSN: 2079-701X; 2658-5790
• DOI: 10.21518/2079-701X-2017-17-124-131

Currently, nonsteroidal anti-inflammatory drugs (NSAIDs) are a major component of pharmacotherapy of chronic rheumatic pain and are the most commonly prescribed drugs. The cyclooxygenase (COX) – a key enzyme in the synthesis of prostaglandins (PG) mediating the inflammation development – is the target for NSAIDs. The use of NSAIDs is associated with risk of mucosal damage of the gastrointestinal tract (GIT). Its protection is carried out with the participation of PG, the synthesis of which is controlled primarily by COX1, to a lesser extent – by COX2, inducing an inflammatory process. Therefore, one of the most effective measures to prevent disorders of the gastrointestinal tract, was the development of drugs that selectively inhibit the activity of COX2. Such drugs include, in particular, nimesulide (NM Nimesin, Shreya Life Senses). In addition to synthesis of PG-mediated COX2, NM inhibits a number of other mechanisms involved in the development of the inflammatory process. The ability of the NM to act simultaneously on many parts of the inflammatory process allows successfully using it in various inflammation-associated disease. NM was covered in over 200 clinical trials that included more than 90 thousand patients with acute and chronic diseases accompanied by pain syndrome. These authors demonstrated that NM can significantly reduce pain, being not inferior by effectiveness than any of the NSAIDs both: selective and non-selective. At the same the sparing effect of NM on COX1 allows maintaining sufficient concentration of prostanoids, providing physiological protection of the mucosa and reducing the frequency of adverse reactions from the GIT.