Document Detail


A Review of the Efficacy, Safety, and Cost-Effectiveness of COX-2 Inhibitors for Africa and the Middle East Region.
MedLine Citation:
PMID:  22931375     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
  Despite an increasingly sophisticated understanding of pain mechanisms, acute and chronic pain remain undertreated throughout the world. This situation reflects the large gap that exists between evidence and practice in pain management and is typified by inappropriate use of nonsteroidal anti-inflammatory drugs (NSAIDs). The scientific evidence around these drugs continues to expand at a high rate, yet physicians are often unaware of best practice. To address this gap among physicians in Africa and the Middle East, an Expert Panel meeting was convened with representatives from the region. The principal objective of the meeting was to review the latest guidelines on the management of acute and chronic pain and to review the efficacy, safety, and cost-effectiveness of cyclooxygenase-2 (COX-2) inhibitors in these settings. The main outcome of this review process was a number of consensus statements concerning the definitions of acute and chronic pain, and the efficacy, safety and cost-effectiveness of traditional nonselective NSAIDs (nsNSAIDs) and selective COX-2 inhibitors (coxibs). The panel agreed that nsNSAIDs and coxibs are effective analgesics with similar efficacy for acute pain; for chronic musculoskeletal pain, NSAIDs are significantly more effective than either placebo or paracetamol. Coxibs offer important safety advantages over nsNSAIDs, including gastrointestinal safety and preservation of platelet function; notably, the cardiovascular safety of coxibs has been the subject of much recent debate. Furthermore, the panel agreed there is substantial evidence to indicate that cost savings can be achieved by using celecoxib in patients at moderate to high risk of gastrointestinal adverse events, even in countries with moderate healthcare expenditures.
Authors:
Anwar Z Zeidan; Bashar Al Sayed; Naceur Bargaoui; Mourad Djebbar; Malik Djennane; Royden Donald; Khamis El Deeb; Raed A Joudeh; Abdullah Nabhan; Stephan A Schug
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-30
Journal Detail:
Title:  Pain practice : the official journal of World Institute of Pain     Volume:  -     ISSN:  1533-2500     ISO Abbreviation:  Pain Pract     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130835     Medline TA:  Pain Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Pain Practice © 2012 World Institute of Pain.
Affiliation:
Faculty of Medicine, Alexandria University, Alexandria, Egypt Dallah Hospital, Riyadh, Saudi Arabia Orthopaedic Clinic, Ibn Al Nafees Hospital, Manama, Bahrain Department of Rheumatology, Monastir University Hospital, Monastir, Tunisia Private Practice In Rheumatology, Oran, Algeria Department of Rheumatology, Tizi Ouzou University Hospital, Tizi Ouzou, Algeria Department of Anaesthesiology, Vergelegen Medi-Clinic, Cape Town, South Africa Private Practice in Orthopaedic Surgery, Amman, Jordan Dr Sulaiman Al Habib Bone, Joint and Spine Hospital, Riyadh, Saudi Arabia Department of Anaesthesia & Pain Medicine, University of Western Australia, Royal Perth Hospital, Perth, Australia.
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