Non-steroidal anti-inflammatory drugs, basis for variability in response

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed groups of drugs in the community. This reflects the high frequency of rheumatic complaints but may in part be due to the relative non efficacy of these drugs. Since the introduction of ibuprofen, the first new NSAID to compete with aspirin, phenylbutazone and indomethacin, there has been a proliferation of new NSAIDs of differing chemical classes but an apparent similar spectrum of action. Despite the fact that these drugs are thought to work by an apparent common mechanism of action (suppression of prostaglandin synthetase activity) continued development of these drugs occurs. There exists at present a conflict between the pharmaceutical industry with its attempts to introduce new NSAIDs and drug regulatory authorities who are generally not convinced of the need for additional drugs of_ this class. The practising clinician regards a variety of NSAIDs as necessary to enable pain relief to be optimised. with minimal adverse effects. With respect to the dilemma of how many NSAIDs are really necessary surprisingly little convincing data is available to assist in resolving this issue. It was therefore decided to hold a satellite meeting to the XVIth International League Against Rheumatism Conference in May 1985.