Non-steroid anti-inflammatory drugs in musculoskeletal pain syndrome therapy: Aspects of their effective and safe use

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Considerable medical and social significance of musculoskeletal system pathology is due to their wide prevalence, big negative impact at the physical and psycho-emotional state, quality of life and working capacity of patients. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in the treatment of acute and subacute musculoskeletal pain. The subject of serious concern of specialists is the high incidence of serious adverse reactions with the systemic use of these preparations. There are several ways to improve the safety of NSAIDs therapy, including use of dosage forms for external application, which is one of the best approaches to reduce the risk of unwanted side effects. Among the external forms of NSAIDs, transdermal patches deserve special attention. They provided the accuracy of the dosing regimen, ease of use, efficacy and safety of therapy.

Full Text

Restricted Access

About the authors

Yulia M. Dronova

N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: y.dronova@yandex.ru
ORCID iD: 0000-0003-4513-091X

PhD in Medical Sciences, Associate Professor of the Department of Clinical Pharmacology

Russian Federation, Voronezh

Olga A. Mubarakshina

N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia

Email: mubarakshina@mail.ru

PhD in Medical Sciences, Associate Professor of the Department of Clinical Pharmacology

Russian Federation, Voronezh

Sergey Yu. Chernov

N.N. Burdenko Voronezh State Medical University of the Ministry of Healthcare of Russia

Email: sergeych6868@mail.ru
ORCID iD: 0009-0002-8900-7745

PhD in Medical Sciences, Associate Professor of the Department of Clinical Pharmacology

Russian Federation, Voronezh

References

  1. Латышева Н.В., Пилипович А.А., Данилов А.Б. Скелетно-мышечные боли. РМЖ. 2014; 22(32): 24–27. [Latysheva N.V., Pilipovich A.A., Danilov A.B. Musculoskeletal pain. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2014; 22(32): 24–27 (In Russ.)]. EDN: TPXGJR.
  2. Каратеев А.Е. Хроническая скелетно-мышечная боль: патогенез, особенности клиники, возможности терапии. Клиническая медицина. 2022; 100(11–12): 527–534. [Karateev A.E. Chronic musculoskeletal pain: pathogenesis, clinical features, therapy possibilities. Klinicheskaya meditsina = Clinical Medicine. 2022; 100(11–12): 527–534 (In Russ.)]. https://dx.doi.org/10.30629/0023-2149-2022-100-11-12-527-534. EDN: VDLDFF.
  3. Пилипович А.А., Данилов А.Б. Миофасциальный болевой синдром: от патогенеза к лечению. РМЖ. Болевой синдром. 2012; 29–32. [Pilipovich A.A., Danilov A.B. Myofascial pain syndrome: from pathogenesis to treatment. Russkiy meditsinskiy zhurnal. Bolevoy sindrom = Russian Medical Journal. Pain Syndrome. 2012; 29–32 (In Russ.)].
  4. Каратеев А.Е. Контроль скелетно-мышечной боли: можно ли создать общий алгоритм терапии? Клиническая фармакология и терапия. 2016; 25(2): 43–53. [Karateev A.E. Is it possible to develop a general algorythm of treatment for musculoskeletal pain? Klinicheskaya farmakologiya i terapiya = Clinical Pharmacology and Therapy. 2016; 25(2): 43–53 (In Russ.)]. EDN: WWVTMX.
  5. Каратеев А.Е. Скелетно-мышечная боль: определение клинических фенотипов и рационального подхода к лечению. Альманах клинической медицины. 2019; 47(5): 445–453. [Karateev A.E. Musculoskeletal pain: Determination of clinical phenotypes and the rational treatment approach. Al’manakh klinicheskoy meditsiny = Almanac of Clinical Medicine. 2019; 47(5): 445–453 (In Russ.)]. https://dx.doi.org/10.18786/2072-0505-2019-47-042. EDN: OHHPCT.
  6. Шостак Н.А., Клименко А.А. Нестероидные противовоспалительные препараты – современные аспекты их применения. Клиницист. 2013; 7(3–4): 53–61. [Shostak N.A., Klimenko A.A. Nonsteroidal anti-inflammatory drugs: current aspects of their use. Klinitsist = The Clinician. 2013; 7(3–4): 53–61 (In Russ.)]. https://dx.doi.org/10.17650/1818-8338-2013-3-4-53-61. EDN: SHUGQH.
  7. Марусиченко В.В. Скелетно-мышечные болевые синдромы: от патогенетических особенностей к рациональным терапевтическим подходам. Международный неврологический журнал. 2019; (4): 68–72. [Marusichenko V.V. Musculoskeletal pain syndrome: from pathogenetic features to rational therapeutic management. Mezhdunarodnyy nevrologicheskiy zhurnal = International Neurological Journal. 2019; (4): 68–72 (In Russ.)]. https://dx.doi.org/10.22141/2224-0713.4.106.2019.174055. EDN: VWSRIE.
  8. Пилипович А.А., Данилов А.Б. Дифференцированный подход к терапии боли: роль нестероидных противовоспалительных препаратов. РМЖ. Болевой синдром. 2013; 18–21. Доступ: https://www.rusmedreview.com/upload/iblock/435/RMJ_Bolevoy_Sindrom_2013_Layout%201.pdf (дата обращения – 01.06.2023). [Pilipovich A.A., Danilov A.B. Differentiated approach to pain therapy: The role of non-steroidal anti-inflammatory drugs. Russkiy meditsinskiy zhurnal. Bolevoy sindrom = Russian Medical Journal. Pain Syndrome. 2013; 18–21. URL: https://www.rusmedreview.com/upload/iblock/435/RMJ_Bolevoy_Sindrom_2013_Layout%201.pdf (date of access – 01.06.2023) (In Russ.)].
  9. Кукушкин М.Л. Алгоритмы диагностики и лечения боли в спине. РМЖ. Медицинское обозрение. 2014; 22(11): 844–847. [Kukushkin M.L. Algorithms for the diagnosis and treatment of back pain. Russkiy meditsinskiy zhurnal. Meditsinskoye obozreniye = Russian Medical Journal. Medical Review. 2014; 22(11): 844–847 (In Russ.)]. EDN: SKBNPH.
  10. Давыдов О.С. Хронизация боли: факторы риска, механизмы и возможности предупреждения. Лечащий врач. 2017; (5): 6–11. [Davydov O.S. Chronicization of pain: Risk factors, mechanisms and possibilities of prevention. Lechashchiy vrach = Attending Physician. 2017; (5): 6–11 (In Russ.)]. EDN: YPWMAV.
  11. Стуров Н.В., Кузнецов В.И. Клинико-фармакологическая характеристика НПВС для врача общей практики. Земский врач. 2011; (1): 11–14. [Sturov N.V., Kuznetsov V.I. Clinical and pharmacological characteristics of NSAIDS for general practitioners. Zemskiy vrach = Zemsky Doctor. 2011; (1): 11–14 (In Russ.)]. EDN: OHWWOF.
  12. Довгань Е.В. Клиническая фармакология нестероидных противовоспалительных препаратов: курс – на безопасность. РМЖ. 2017; 25(13): 979–985. [Dovgan E.V. Clinical pharmacology of non-steroidal anti-inflammatory drugs: A course – on safety. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2017; 25(13): 979–985 (In Russ.)]. EDN: ZIHBDF.
  13. Harirforoosh S., Asghar W., Jamali F. Adverse effects of nonsteroidal antiinflammatory drugs: An update of gastrointestinal, cardiovascular and renal complications. J Pharm Pharm Sci. 2013; 16(5): 821–47. https://dx.doi.org/10.18433/J3VW2F.
  14. Рязанова А.Ю., Магницкая О.В., Горюшкина А.А. Нестероидные противовоспалительные средства как фактор риска сердечно-сосудистых осложнений. Лекарственный вестник. 2013; 7(3): 40–47. [Ryazanova A.Yu., Magnitskaya O.V., Goryushkina A.A. Non-steroidal anti-inflammatory drugs as a risk factor for cardiovascular complications. Lekarstvennyy vestnik = Medicinal Herald. 2013; 7(3): 40–47 (In Russ.)]. EDN: WYGOTJ.
  15. Аникин Г.С., Стожкова И.В., Кукес В.Г. Нестероидные противовоспалительные препараты: безопасность с позиции доказательной медицины. Хирургия. Приложение к журналу Consilium Medicum. 2017; (2): 28–32. [Anikin G.S., Stozhkova I.V., Kukes V.G. NSAIDS: Safety from the point of evidence-based medicine. Khirurgiya. Prilozheniye k zhurnalu Consilium Medicum = Surgery. Supplement to Consilium Medicum. 2017; (2): 28–32 (In Russ.)]. https://dx.doi.org/10.26442/2075-1753_19.7.2.28-32. EDN: YMLCZA.
  16. Nawaz F.A., Larsen C.P., Troxell M.L. Membranous nephropathy and nonsteroidal anti-inflammatory agents. Am J Kidney Dis. 2013; 62(5): 1012–17. https://dx.doi.org/10.1053/j.ajkd.2013.03.045.
  17. Lipworth L., Abdel-Kader K., Morse J. et al. High prevalence of non-steroidal anti-inflammatory drug use among acute kidney injury survivors in the southern community cohort study. BMC Nephrol. 2016; 17(1): 189. https://dx.doi.org/10.1186/s12882-016-0411-7.
  18. Unzueta A., Vargas H.E. Nonsteroidal anti-inflammatory druginduced hepatoxicity. Clin Liver Dis. 2013; 17(4): 643–56, ix. https://dx.doi.org/10.1016/j.cld.2013.07.009.
  19. Cheung K.S., Leung W.K. Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management. World J Gastroenterol. 2017; 23(11): 1954–63. https://dx.doi.org/10.3748/wjg.v23.i11.1954.
  20. Мороз Е.В., Каратеев А.Е., Крюков Е.В., Чернецов В.А. Желудочно-кишечные кровотечения при использовании новых пероральных антикоагулянтов: эпидемиология, факторы риска, лечение и профилактика. Научно-практическая ревматология. 2017; 55(6): 675–684. [Moroz E.V., Karateev A.E., Kryukov E.V., Chernetsov V.A. Gastrointestinal bleeding with the use of new oral anticoagulants: Epidemiology, risk factors, treatment, and prevention. Nauchno-prakticheskaya revmatologiya = Scientific and Practical Rheumatology. 2017; 55(6): 675–684 (In Russ.)]. https://dx.doi.org/10.14412/1995-4484-2017-675-684. EDN: YPXRFB.
  21. Каратеев А.Е. Насколько оправдано применение инъекционных форм нестероидных противовоспалительных препаратов? РМЖ. Медицинское обозрение. 2020; 4(8): 518–524. [Karateev A.E. Justification of the use of non-steroidal anti-inflammatory drugs injectable forms. Russkiy meditsinskiy zhurnal. Meditsinskoye obozreniye = Russian Medical Journal. Medical Review. 2020; 4(8): 518–524 (In Russ.)]. https://dx.doi.org/10.32364/2587-6821-2020-4-8-518-524. EDN: FSUPKX.
  22. Каратеев А.Е., Насонов Е.Л., Ивашкин В.Т. с соавт. Рациональное использование нестероидных противовоспалительных препаратов. Клинические рекомендации. Научно-практическая ревматология. 2018; 56 (S1): 1–29. [Karateev A.E., Nasonov E.L., Ivashkin V.T. et al. Rational use of nonsteroidal anti-inflammatory drugs. Clinical guidelines. Nauchno-prakticheskaya revmatologiya = Scientific and Practical Rheumatology. 2018; 56 (S1): 1–29 (In Russ.)]. https://dx.doi.org/10.14412/1995-4484-2018-1-29. EDN: PCPKRP.
  23. Moore A., Makinson G., Li C. Patient-level pooled analysis of adjudicated gastrointestinal outcomes in celecoxib clinical trials: Meta-analysis of 51,000 patients enrolled in 52 randomized trials. Arthritis Res Ther. 2013; 15(1): R6. https://dx.doi.org/10.1186/ar4134.
  24. Feng X., Tian M., Zhang W., Mei H. Gastrointestinal safety of etoricoxib in osteoarthritis and rheumatoid arthritis: A metaanalysis. PLoS One. 2018; 13(1): e0190798. https://dx.doi.org/10.1371/journal.pone.0190798.
  25. Nissen S.E., Yeomans N.D, Solomon D.H. et al. Cardiovascular safety of celecoxib, naproxen, or ibuprofen for arthritis. N Engl J Med. 2016; 375(26): 2519–29. https://dx.doi.org/10.1056/NEJMoa1611593.
  26. Laine L., Goldkind L., Curtis S.P. et al. How common is diclofenac-associated liver injury? Analysis of 17,289 arthritis patients in a long-term prospective clinical trial. Am J Gastroenterol. 2009; 104(2): 356–62. https://dx.doi.org/10.1038/ajg.2008.149.
  27. Shin B.J., Kim T.K., Baik J.S., Shim D.M. Comparison the safety and the efficacy between the group of using pelubiprofen tab. and the group of using aceclofenac tab. on back pain patients - multi institution, double blind, random sample. J Korean Soc Spine Surg. 2012; 19(2): 38–46. https://dx.doi.org/10.4184/jkss.2012.19.2.38.
  28. Choi I.A., Baek H.J., Cho C.S. et al. Comparison of the efficacy and safety profiles of a pelubiprofen versus celecoxib in patients with rheumatoid arthritis: A 6-week, multicenter, randomized, double-blind, phase III, non-inferiority clinical trial. BMC Musculoskeletal Disord. 2014, 15: 375. https://dx.doi.org/10.1186/1471-2474-15-375.
  29. TrialBulletin.com. Phase III study of CG100649 in osteoarthritis patients. URL: https://trialbulletin.com/lib/entry/ct-01765296 (date of access – 01.06.2023).
  30. Scarpignato C., Gatta L., Zullo A. et al. Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harms of acid suppression. BMC Med. 2016; 14(1): 179. https://dx.doi.org/10.1186/s12916-016-0718-z.
  31. Zhang S., Qing Q., Bai Y. et al. Rebamipide helps defend againstnonsteroidal anti-inflammatory drugs induced gastroenteropathy: A systematic review and meta-analysis. Dig Dis Sci. 2013; 58(7): 1991–2000. https://dx.doi.org/10.1007/s10620-013-2606-0.
  32. Meng Z., Huang R. Topical treatment of degenerative knee osteoarthritis. Am J Med Sci. 2018; 355(1): 6–12. https://dx.doi.org/10.1016/j.amjms.2017.06.006.
  33. Derry S., Moore R.A., Gaskell H. et al. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015; 2015(6): CD007402. https://dx.doi.org/10.1002/14651858.CD007402.pub3.
  34. Kneer W., Rother I., Rother M. et al. A multiple-dose, open-label, safety, compliance, and usage evaluation study of epicutaneously applied Diractin (ketoprofen in Transfersome) in joint/musculoskeletal pain or soft tissue inflammation. Curr Drug Saf. 2009; 4(1): 5–10. https://dx.doi.org/10.2174/157488609787354468
  35. Baraf H.S., Gloth F.M., Barthel H.R. et al. Safety and efficacy of topical diclofenac sodium gel for knee osteoarthritis in elderly and younger patients: pooled data from three randomized, doubleblind, parallel-group, placebo-controlled, multicentre trials. Drugs Aging. 2011; 28(1): 27–40. https://dx.doi.org/10.2165/11584880-000000000-00000.
  36. Клинические рекомендации. Гонартроз. Ассоциация травматологов-ортопедов России. Ассоциация ревматологов России. Рубрикатор клинических рекомендаций Минздрава России. 2021. ID: 667. Доступ: https://cr.minzdrav.gov.ru/schema/667_1 (дата обращения – 01.06.2023). [Clinical guidelines. Gonarthrosis. Russian Association of Traumatologists and Orthopedists. Association of Rheumatologists of Russia. Rubricator of clinical recommendations of the Ministry of Healthcare of Russia. 2021. ID: 667. URL: https://cr.minzdrav.gov.ru/schema/667_1 (date of access – 01.06.2023) (In Russ.)].
  37. Клинические рекомендации. Дегенеративные заболевания позвоночника. Российская ассоциация хирургов-вертебрологов, Ассоциация нейрохирургов России, Ассоциация травматологов-ортопедов России. Рубрикатор клинических рекомендаций Минздрава России. 2021. ID: 727. Доступ: https://cr.minzdrav.gov.ru/schema/727_1 (дата обращения – 01.06.2023). [Clinical guidelines. Degenerative diseases of the spine. Russian Association of Spine Surgeons, Russian Association of Neurosurgeons, Russian Association of Orthopedic Traumatologists. Rubricator of clinical recommendations of the Ministry of Healthcare of Russia. 2021. ID: 727. URL: https://cr.minzdrav.gov.ru/schema/727_1 (date of access – 01.06.2023) (In Russ.)].
  38. Каратеев А.Е., Лила А.М. Локальные формы НПВП: современный взгляд на эффективность и безопасность. РМЖ. Медицинское обозрение. 2019; 3(11–2): 75–80. [Karateev A.E., Lila A.M. Topical NSAIDS forms: Efficiency and safety. Russkiy meditsinskiy zhurnal. Meditsinskoye obozreniye = Russian Medical Journal. Medical Review. 2019; 3(11–2): 75–80 (In Russ.)]. EDN: BVTAHI.
  39. Годзенко А.А., Бадокин В.В. Локальная терапия миофасциального болевого синдрома. РМЖ. 2007; 15(26): 1998–2003. [Godzenko A.A., Badokin V.V. Local therapy of myofascial pain syndrome. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2007; 15(26): 1998–2003 (In Russ.)].
  40. Лосенкова С.О. Трансдермальные терапевтические системы. Экспериментальная и клиническая фармакология. 2008; 71(6): 54–57. [Losenkova S.O. Transdermal therapeutic systems. Eksperimental’naya i klinicheskaya farmakologiya = Experimental and Clinical Pharmacology. 2008; 71(6): 54–57 (In Russ.)]. EDN: TNKDSL.
  41. Шестаков Н.В., Пятигорская Н.В. Нестероидные противовоспалительные средства при скелетно-мышечных болях: преимущества трансдермальных терапевтических систем. РМЖ. 2019; 27(4): 28–31. [Shestakov N.V., Pyatigorskaya N.V. Nonsteroidal anti-inflammatory drugs in musculoskeletal pains: Benefits from transdermal therapeutic systems. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2019; 27(4): 28–31 (In Russ.)]. EDN: WMZUIG.
  42. Леонова М.В. Трансдермальные пластыри, содержащие нестероидные противовоспалительные препараты: клинико-фармакологическая характеристика. Справочник поликлинического врача. 2019; (3): 5–22. [Leonova M.V. Transdermal patches containing non-steroidal anti-inflammatory drugs: clinical and pharmacological characteristics. Spravochnik poliklinicheskogo vracha = Handbook for Practitioners Doctors. 2019; (3): 5–22 (In Russ.)]. EDN: LAIGDT.
  43. Nair B., Taylor-Gjevre R. A review of topical diclofenac use in musculoskeletal disease. Pharmaceuticals (Basel). 2010; 3(6): 1892–908. https://dx.doi.org/10.3390/ph3061892.
  44. Keith A.D. Polymer matrix consideration for transdermal devices. Drug Dev Ind Pharm. 1983; (9): 605–21.
  45. Mazieres B. Topical ketoprofen patch. Drugs R D. 2005; 6(6): 337–44. https://dx.doi.org/10.2165/00126839-200506060-00003.
  46. Derry S., Conaghan P., Da Silva J.A. et al. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016; 4(4): CD007400. https://dx.doi.org/10.1002/14651858.CD007400.pub3.
  47. Simon L.S., Grierson L.M., Naseer Z. et al. Efficacy and safety of topical diclofenac containing dimethyl sulfoxide (DMSO) compared with those of topical placebo, DMSO vehicle and oral diclofenac for knee osteoarthritis. Pain. 2009; 143(3): 238–45. https://dx.doi.org/10.1016/j.pain.2009.03.008.
  48. Peterson K., McDonagh M., Thakurta S. et al. Drug class review: Nonsteroidal antiinflammatory drugs (NSAIDs): Final update 4 report [Internet]. Portland (OR): Oregon Health & Science University. 2010 Nov. URL: http://www.ncbi.nlm.nih.gov/books/NBK539602010 (date of access – 01.06.2023).
  49. Komatsu T., Sakurada T. Comparison of the efficacy and skin permeability of topical NSAID preparations used in Europe. Eur J Pharm Sci. 2012; 47(5): 890–95. https://dx.doi.org/10.1016/j.ejps.2012.08.016.
  50. Shainhouse J.Z., Grierson L.M., Naseer Z. A long-term, open-label study to confirm the safety of topical diclofenac solution containing dimethyl sulfoxide in the treatment of the osteoarthritic knee. Am J Ther. 2010; 17(6): 566–76. https://dx.doi.org/10.1097/MJT.0b013e3181d169b5.
  51. Государственный реестр лекарственных средств Минздрава России. Инструкция по медицинскому применению лекарственного препарата ДиклАртис. РУ: ЛП-007110. Доступ: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=6ee90586-dfef-4365-9b9f-c3c013ae85ae (дата обращения – 01.05.2023). [State Register of Medicines of the Ministry of Healthcare of Russia. DiclArtis. Patient information leaflet. Registration certificate: ЛП-007110. URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=6ee90586-dfef-4365-9b9f-c3c013ae85ae (date of access – 01.05.2023) (In Russ.)].
  52. Государственный реестр лекарственных средств Минздрава России. Инструкция по медицинскому применению лекарственного препарата КетАртис. РУ: ЛП-007505. Доступ: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=a201ffcb-9756-4aab-a411-5c6fe5aad3b7 (дата обращения – 01.05.2023). [State Register of Medicines of the Ministry of Healthcare of Russia. KetArtis. Patient information leaflet. Registration certificate: ЛП-007505. URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=a201ffcb-9756-4aab-a411-5c6fe5aad3b7 (date of access – 01.05.2023) (In Russ.)].

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies