Naturalistic survey on nonsteroidal antiinflammatory treatment in patients with musculoskeletal pain

Objective and methods. - To evaluate patients' opinions about the gastrointestinal safety and areas for improvement of conventional nonsteroidal antiinflammatory drug (NSAID) therapy for musculoskeletal pain, the Louis Harris Institute conducted a survey in 401 patients selected in France using a quota sampling method. Results. - Three hundred and five patients (76%) described their pain as incapacitating. Nearly, one-third of the patients (125/401, 31%) reported gastrointestinal side effects, which prompted endoscopy in 24 (24/125, 20%) and gastroprotective drug treatment (usually by a proton pump inhibitor) in 100 (100/125, 82%). NSAID discontinuation or dosage reduction because of gastrointestinal side effects occurred in 55 patients (55/125, 45%), at the cost of symptom exacerbation, including worse pain, in over half the cases. Among the 401 patients, 304 (76%) wanted more effective NSAIDs and 174 (43%) wanted better gastrointestinal tolerability. Conclusion. - Under everyday conditions, the use and effectiveness of conventional NSAID therapy are limited by gastrointestinal side effects. Furthermore, patients want NSAIDs with better risk/benefit ratios to control musculoskeletal pain. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.