NSAIDs and Aspirin: Recent Advances and Implications for Clinical Management

271 Pages·2016·5.286 MB·English

by  Angel Lanas (eds.)

Angel Lanas
Editor
NSAIDs and Aspirin
Recent Advances and
Implications for
Clinical Management
123
NSAIDs and Aspirin

Angel Lanas
Editor
NSAIDs and Aspirin
Recent Advances and Implications
for Clinical Management
Editor
AngelLanas
UniversidaddeZaragoza
IISArago´n,CIBEREnfermedadesHepa´icas
yDigestivas(CIBERehd)
Zaragoza,Spain
Serviceof Digestive Diseases
University Hospital Lozano Blesa
Zaragoza,Spain
ISBN978-3-319-33887-3 ISBN978-3-319-33889-7(eBook)
DOI10.1007/978-3-319-33889-7
LibraryofCongressControlNumber:2016945854
#SpringerInternationalPublishingSwitzerland2016
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Preface
NSAIDs are one of the most widely prescribed drugs around the world to
treatpainandinflammation.Prescribersofthesedrugsincludeawiderange
of medical specialties, including general practitioners, rheumatologists,
oncologists, orthopedists, and trauma and internal medicine specialists.
Gastroenterologists have a special interest on these compounds based on
thegastrointestinaladverseeventsderivedfromtheiruseandtherecentdata
oncolorectalcancerpreventionwithaspirinandNSAIDs.
The field has underwent great changes and outstanding new advances in
thelast10years,whichhavechangedtheprescriptionhabits,guidelines,and
new restrictions and recommendations made by international regulatory
agencies such as the FDA or the EMA. The knowledge and advances have
been produced essentially since the development of the new class of drugs
thatinhibitedselectivelytheCOX-2isozyme.Theclinicaluseofthesenew
compounds uncovered adverse effects that had been hidden to the eyes of
investigators. In this way, today we know that the use of either COX-2
selective inhibitors or traditional NSAIDs is associated with adverse events
not only from the upper GI tract but from the lower GI tract and the CV
system.AdvancesonthisareahaveprovedthatCOX-1andCOX-2products
areinvolvednotonlyinpainandinflammationbutincancerdevelopmentas
well.Infact,mostoutstandingadvancesinthefieldwherediscoveredwhen
these drugs were tested to prevent gastrointestinal cancer. These advances
andknowledgecannotbeseparated todayfromtheeffectsofaspirinonthe
cardiovascular system and on cancer prevention and treatment. In addition
aspirinisstillbeingusedfortheshort-termtreatmentofcold,fever,andpain.
This book provides a comprehensive state-of-the art review of all these
aspectsandwillserveasreferencebookfortheclinicianandthosewholook
for an update and summary of the recent advances of the field in the last
10 years. The book will provide practical recommendations for a safe
prescription of NSAID based on the most recent knowledge. I expect these
recommendationswilllastforsometimesincenonewrelevantadvancesare
expectedonthistopicinthenextfewyears.Thebookincludesalsochapters
specificallyfocusedonaspirinandthecardiovascularsystemandcancer,hot
topics that are evolving rapidly in the last few years and that are closely
linkedtotheNSAIDfieldandcannotbeleftoutinabookofthistype.Infact,
thelastpartofthisbookisdedicatedtotheimpactofNSAIDsandespecially
v
vi Preface
ofaspirinoncancerpreventionandtreatment.Thismakesthebookcompre-
hensiveinmostaspectsrelatedwithNSAIDsandaspirinuseandgoesfrom
basicsciencetopracticalclinicalrecommendations.
All chapters have been written by worldwide renowned and outstanding
specialists inthefield.Allauthors hadinvestigated extensively onthis area
andhaveatremendousclinicalexperience.Ihadhadtheprivilegeofworking
withmostofthemand/orhadscientificdiscussionandinteractionwithallof
themforyears.Here,Ineedtoexpressmymostsinceregratitudetothemfor
beingabletowritethesechaptersdespiteofhavingverybusyagendas.Iam
indebtwiththemandhopetheirworkwillberecompensedbytheinterestthe
bookwillarouseamongthereaders.
Zaragoza,Spain AngelLanas
Acknowledgments
Theeditorneedstoexpressherehismostsinceregratitudetoallauthorsfor
writing exceptional chapters and all the work done to make this book
possible. In particular to Sara Calatayud, Juan Vicente Esplugues, Bibiana
Rius,andJoanClar´ıaforthefirstsectionofthebookonpharmacologyand
mechanisms of action of NSAIDs. To Marc Hochberg, Lee Simon, Sunny
H. Wong, Francis K.L. Chan, Carmelo Scarpignato, Corrado Blandizzi,
Mohammad Yaghoobi, and Richard Hunt for the section on clinical effects
and safety of NSAID treatments. To Karsten Schro¨r, Michael Voelker,
DennisMcCarthy,RubenCasado-Arroyo,PedroBrugada,KatsunoriIijima,
Sara Wood, and Charles Hennekens for the section on pharmacodynamics,
pharmacokinetics, and all clinical aspects related with aspirin use. Finally,
my most sincere thanks to Anna Lisa Bruno, Melania Dovizio, Paola
Patrignani, Elena Piazuelo, Paul J. Lochhead, Andrew T. Chan, Elizabeth
Half,AhmadFokra,andNadirArberfortheirexceptionalworkdoneonthe
impact and effects of NSAIDs and aspirin on colorectal cancer prevention
andtreatment.
vii

Contents
PartI PharmacologyandMechanisms
1 Chemistry,Pharmacodynamics,andPharmacokinetics
ofNSAIDs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SaraCalatayudandJuanVicenteEsplugues
2 Principles,MechanismsofAction,andFuture
ProspectsofAnti-inflammatoryDrugs. . . . . . . . . . . . . . . 17
BibianaRiusandJoanCla`ria
PartII ClinicalEffectsandDrugSafety
3 EfficacyofNSAIDsintheTreatmentofRheumatic
Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
MarcC.HochbergandLeeS.Simon
4 AdverseEffectsofNSAIDsintheGastrointestinal
Tract:RiskFactorsofGastrointestinalToxicity
withNSAIDs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
SunnyH.WongandFrancisK.L.Chan
5 AdverseEffectsofNonsteroidalAnti-inflammatory
DrugsontheCardiovascularSystem. . . . . . . . . . . . . . . . . 61
CarmeloScarpignatoandCorradoBlandizzi
6 SafePrescriptionofNSAIDsinClinicalPractice. . . . . . . 91
MohammadYaghoobiandRichardH.Hunt
PartIII Aspirin
7 NSAIDSandAspirin:RecentAdvancesandImplications
forClinicalManagement. . . . . . . . . . . . . . . . . . . . . . . . . . 107
KarstenSchro¨randMichaelVoelker
8 NonprescriptionAnalgesicAnti-inflammatoryDrugs:
EfficacyandSafety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
DenisM.McCarthy
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