Pharmacotherapy of chronic back pain: Are there prospects?

Современная ревматология

G. I. Shvartsman¹  A. E. Karateev² 

[1] I.I. Mechnikov North-West State Medical University, Ministry of Health of Russia;V.A. Nasonova Research Institute of Rheumatology;

关键词: chronic back pain;    pharmacotherapy;    nonsteroidal anti-inflammatory drugs;    glucocorticoids;    biological agents;    nerve growth factor inhibitors;    opioids;    antidepressants;    muscle relaxants;    antibiotic therapy;   

DOI  :  10.14412/1996-7012-2017-3-112-120

来源: DOAJ

【 摘 要 】

Treatment for chronic back pain (CBP) is a complex therapeutic challenge. The heterogeneity of the disease, different phenotypes of pain, comorbidities, and individual sensitivity to drugs require the use of a broad-spectrum of analgesics with different mechanisms of action. The present review briefly considers the evidence base of basic pharmacological groups that are used for the treatment of CBP in real clinical practice or in clinical trials: nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, tumor necrosis factor-α (TNF-α) inhibitors, nerve growth factor inhibitors, opioids, antidepressants, and muscle relaxants, as well as antibiotic therapy. It is shown that at the moment there are no existing or promising drugs that are able to completely solve the problem of CBP. Treatment should be initiated with NSAIDs. Although their efficacy in CBP is relatively low; nevertheless, the use of NSAIDs makes it possible to achieve a certain reduction in pain and to create conditions for the successful use of other drug classes and non-drug methods. The benefits of nimesulide that may be deemed to be a first-line drug among NSAIDs are considered in terms of its efficacy, relative safety, and availability.

【 授权许可】

Unknown