CORRELATION BETWEEN NONSTEROIDAL ANTIINFLAMMATORY DRUG EFFICACY IN A CLINICAL PAIN MODEL AND THE DISSOCIATION OF THEIR ANTIINFLAMMATORY ANDANALGESIC PROPERTIES IN ANIMAL-MODELS

Recently our group demonstrated that it is possible to differentiate n onsteroidal anti-inflammatory drugs (NSAIDs) as analgesic agents in th e management of acute musculoskeletal pain. In this paper, we extend t his work to investigate the notion that the analgesic and anti-inflamm atory potency of an NSAID is not simply related through a common mecha nism, namely the inhibition of peripheral prostaglandin (PG) synthesis . Following an extensive survey of the published literature for a seri es of acidic NSAIDs, we could not find any significant correlation bet ween potency as an analgesic agent or as an anti-inflammatory agent an d analgesic efficacy in clinical practice. Importantly, we now demonst rate for the first time that it is potency as an analgesic agent relat ive to potency as an anti-inflammatory agent that covaries with clinic al efficacy. We discuss the possibility that, for a given NSAID, the m agnitude of this dissociation between analgesic and anti-inflammatory potencies may reflect the net effect of a complex interaction between peripheral and central sites of action, and between diverse mechanisms of action that are independent of an inhibition of PG synthesis. Our results provide a clinically meaningful differentiation of NSAIDs thro ugh the use of in vivo data.