WHEN IT COMES TO GI SIDE-EFFECTS, NOT ALL NSAIDS ARE ALIKE.

Perhaps the major barrier to the use of nonsteroidal antiinflammatory agents (NSAIDs) is their propensity to cause gastrointestinal side effects. Physicians can reduce side effects by modulating the dose and prescribing NSAIDs with the lowest side-effect profile. According to this meta- analysis, such an approach has merit.

The authors identified 12 epidemiologic studies that compared the frequency of major GI side-effects in patients taking ibuprofen and at least one other NSAID. Ibuprofen ranked the lowest in terms of GI risk in nearly every study and had the lowest overall relative risk. Diclofenac had the next lowest relative risk (2.3), followed by diflunisal (RR, 3.5) and fenoprofen (RR, 3.5). The drugs with the highest risk included p…