Difficult choice of therapy with NSAIDs to relieve pain in multimorbid patients

E.S. Akarachkova¹, A.R. Artemenko², A.A. Belyaev³, D.V. Blinov⁴, E.V. Bugorkii⁵, L.R. Kadyrova⁶, K.S. Kerimova⁷, L.V. Klimov⁸, O.V. Kotova^1,9, D.I. Lebedeva¹⁰, A.S. Orlova², A.M. Tkachev¹¹, E.V. Tsareva¹², O.N. Yakovlev¹³

¹International Society of Stress “Stress Under Control”, Moscow

²Sechenov University, Moscow

³Research Institute of Emergency Medicine named after N.V. Sklifosovsky, Moscow

⁴IPSOM LLC, Moscow

⁵Almatek LLC, Moscow region, Pavlovskaya Sloboda

⁶Kazan State Medical University, the branch of the Russian Medical Academy of Continuous Professional Education, Kazan

⁷Charitable Endowment “Podsolnukh”, Moscow

⁸Scientific and Practical Center of Pediatric Psychoneurology, Moscow

⁹National Medical Research Center of Cardiology, Moscow

¹⁰Tumen State Medical University, Tumen

¹¹Diagnostic and Treatment Center of the Medical Institute named after Berezin Sergey (LDC MIBS-Volgograd LLC), Volgograd

¹²Unison LLC, Moscow

¹³Psychotherapeutic Outpatient Clinic Median, Trier, Germany

For a primary care physician, NSAIDs are convenient and effective agents for the treatment of pathologies in musculoskeletal system structures. The article presents the essentials when choosing NSAIDs for non-specific low back pain. The probability of an isolated risk in individual organ systems (gastrointestinal tract, cardiovascular system, liver, kidneys) and the combined risks when using NSAIDs is discussed. At present, many researchers stand for a more thorough study of NSAIDs to predict the potential risks of somatic adverse events. This is especially true of new medicines, the clinical profile of which does not allow to substantiate their complete safety. Against this background, special attention should be paid to Movalis^® (meloxicam) — a drug with favourable spectrum of efficacy and safety, which is especially important  in patients with comorbid pathology and/or receiving combined therapy. For more than 20 years, Movalis in approved doses (7.5 mg/day or 15 mg/day) has been successfully used in the treatment of pain syndromes. Thanks to the “favourable history” and extensive experience in clinical practice, Movalis remains a priority in combined treatment and is considered as the “golden mean” of NSAID therapy.

Keywords: meloxicam, NSAIDs, polypragmasia, safety, combined risk, comorbid diseases, multimorbid patient, quality of life.

For citation: Akarachkova E.S., Artemenko A.R., Belyaev A.A. et al. Difficult choice of therapy with NSAIDs to relieve pain in multimorbid patients. RMJ. 2020;8:16–22.