Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Rheumatol. Dec 11, 2018; 8(1): 1-4
Published online Dec 11, 2018. doi: 10.5499/wjr.v8.i1.1
Maligned non-steroidal anti-inflammatory drugs: Misunderstanding of their safety profile in patients with renal insufficiency
Bruce M Rothschild
Bruce M Rothschild, Department of Medicine, Indiana University, Ball Memorial Hospital, Muncie, IN 47304, United States
Author contributions: Rothschild BM conceived the study and drafted the manuscript; author approved the final version of the article.
Conflict-of-interest statement: The author has no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bruce M Rothschild, MD, Professor, Department of Medicine, Indiana University, Ball Memorial Hospital, Muncie, IN 47304, United States. spondylair@gmail.com
Telephone: +1-785-6151523
Received: May 17, 2018
Peer-review started: May 18, 2018
First decision: June 14, 2018
Revised: November 15, 2018
Accepted: November 29, 2018
Article in press: November 29, 2018
Published online: December 11, 2018
Abstract

Non-steroidal anti-inflammatory drugs have a fundamental and pivotal position in management of many of the disorders managed by rheumatologists. Promulgation of a false perspective of their toxicity has compromised our ability to advise our patients and participate in the management of their disorders. The literature sources, from which the false perspective derives, do not accurately reflect safety and fail to address the value of appropriate drug use monitoring. We, as rheumatologists, must stand up and proactively address engrained misconceptions-if we are to be able to continue to provide safe, effective care for our patients.

Keywords: Non-steroidal anti-inflammatory drugs, Renal function, Safety, Toxicity

Core tip: Non-steroidal anti-inflammatory drugs are safe when appropriately dosed and renal function monitored. Evaluation for complete blood count, comprehensive metabolic panel and urinalysis within two weeks of initiation, at dose augmentation and with use of interacting or hemodynamically-altering concomitant medications, and again at a month and at three month intervals provides an appropriate monitoring regimen.