Place of OTC analgesics and NSAIDs in osteoarthritis

The risk related to the use of non-steroid anti-inflammatory drugs (NSAIDs) depends on the dose and duration of their use, in addition to the nature of the drug, and patient characteristics. The measures of risk and recent promotion of safer drugs have been mostly based on the results of clinical trials using continuous full-dose use of NSAIDs for periods up to 12 months which may not reflect real-life use and risks of the drugs. To assess this we did two studies of the utilisation of NSAIDs, one in a claims database to measure the amount of drugs dispensed to OA patients over 9 months, which showed that only a small fraction of patients actually bought enough analgesics or NSAIDs to cover the whole study period. On average, patients bought enough NSAIDs to cover 60 of 270 days. The second study was a survey of General Practitioners and rheumatologists to assess the number of users of NSAIDs seen over 2 days' consultations, the indications for and patterns of NSAIDs use. 11% of GP patients and 26% of rheumatologists' patients used NSAIDs, one-third for osteoarthritis (OA), about 8-10% for rheumatoid arthritis (RA) and the rest for various painful conditions. In OA and other conditions patients, more than 70% of patients had been taking their NSAIDs for less than 15 days at the time of consultation, whereas 42% of RA patients had been taking them for more than 6 months.