This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Østensen, M Articles by Villiger, P M Search for Related Content PubMed PubMed Citation Articles by Østensen, M Articles by Villiger, P M Pubmed/NCBI databases Medline Plus Health Information Lupus Social Bookmarking                   What's this?

Nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus

Department of Rheumatology, and Clinical Immunology and Allergy, University Hospital, CH-3010 Berne, Switzerland, Tel: (41) 31 632 4179; Fax: (41) 31 632 2600;monika.ostensen{at}insel.ch

P M Villiger

Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Berne, Berne, Switzerland

Up to 80% of patients with systemic lupus erythematosus (SLE) are treated with nonsteroidal anti-inflammatory drugs (NSAID) for musculoskeletal symptoms, serositis and headache. This survey reviews the literature on non-selective and selective inhibitors of cyclooxygenases with an emphasis on the efficacy and safety profile reported in SLE patients. No lupus-specific data on gastro-intestinal side effects of NSAID exist. Both non-selective Cox-inhibitors and selective Cox-2 inhibitors induce renal side effects including sodium retention and reduction of the glomerular filtration rate. Lupus nephritis is a risk factor for NSAID-induced acute renal failure, but not for rare idiosyncratic toxic renal reactions to NSAID. In refractory nephrotic syndrome, NSAID have been used successfully. Cutaneous and allergic reactions to NSAID are increased in SLE patients as well as hepatotoxic effects, particularly with high dose aspirin. Whereas a variety of central nervous system side effects of NSAID are probably no more common in SLE patients than in others, aseptic meningitis has been reported more frequently. Ovulation and pregnancy can be adversely affected by Cox-inhibitors. The antiplatelet effect of aspirin and non-selective Cox-inhibitors has a therapeutic potential in patients with the antiphospholipid syndrome (APS). In summary, treatment of SLE with NSAID requires awareness for the increased frequency of some side effects and close monitoring of toxicity.

Key Words: systemic lupus erythematosus • Cox-1 inhibitors • Cox-2 inhibitors • side effects • practice points

Lupus, Vol. 10, No. 3, 135-139 (2001)
DOI: 10.1191/096120301668183556


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. Li, D. Barnes, D. Butz, D. Bjorling, and M. E. Cook 10t,12c-conjugated linoleic acid inhibits lipopolysaccharide-induced cyclooxygenase expression in vitro and in vivo J. Lipid Res., October 1, 2005; 46(10): 2134 - 2142. [Abstract] [Full Text] [PDF]

				D Talaulikar, K E Tymms, I Prosser, and R Smith Autologous peripheral blood stem cell transplantation with in vivo T-cell depletion for life threatening refractory systemic lupus erythematosus Lupus, February 1, 2005; 14(2): 159 - 163. [Abstract] [PDF]

				R. K. Burt, S. Slavin, W. H. Burns, and A. M. Marmont Induction of tolerance in autoimmune diseases by hematopoietic stem cell transplantation: getting closer to a cure? Blood, February 1, 2002; 99(3): 768 - 784. [Abstract] [Full Text] [PDF]

				G. B. Mills Mechanisms Underlying Chemoprevention of Ovarian Cancer Clin. Cancer Res., January 1, 2002; 8(1): 7 - 10. [Abstract] [Full Text] [PDF]

				S E Walker Bromocriptine treatment of systemic lupus erythematosus Lupus, October 1, 2001; 10(10): 762 - 768. [Abstract] [PDF]