Therapeutics of Ibuprofen in Rheumatic and Other Chronic and Painful Diseases

In many of the phase III and IV trials featuring the newer NSAIDs and the coxibs, ibuprofen was used as a comparison for the establishment of efficacy as well as safety. As a result a large amount of data has been accumulated on the clinical effects of these drugs in comparison with ibuprofen, some of which is reviewed in this chapter. There is evidence to show that ibuprofen is a safe and effective ‘first-line’ NSAID for many rheumatic patients. The evidence shows that mostly it is preferable to paracetamol in osteoarthritis. Aspects of the clinical pharmacology and toxicology of ibuprofen relevant to its use in rheumatic diseases and various pain states are briefly reviewed. Ibuprofen has a general profile of adverse drug reactions (ADRs) and toxicity that is similar to that of other NSAIDs in rheumatic patients. The chapter focuses on rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), and osteoarthritis.