Historical overview of non-steroidal anti-inflammatory drugs.

Non-steroidal anti-inflammatory drugs (NSAIDs) are efficacious in the control of arthritis symptoms and have become the mainstay of arthritis therapy. While NSAIDs' chief mechanism of action has long been assumed to be the inhibition of prostaglandin synthesis, further investigation has implicated additional mechanisms, and shed light upon additional side-effects. Adverse renal effects and effects on bone and cartilage metabolism are counted among worrisome NSAID-induced side-effects, but gastrointestinal side-effects represent the greatest threat to chronic NSAID users. It is important that we combine documented experience of side-effect risk with our growing knowledge of potential risk to frame a prescriptive approach to the arthritis patient that encompasses symptom management as well as patient protection.