Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Sarcoidosis is characterized by clumps of immune cells called granulomas that build up in one or more parts of the body. These can cause chronic inflammation and prevent the normal function of organs.

There is no cure for sarcoidosis, but there are various therapies that can help manage the symptoms of the condition. Non-steroidal anti-inflammatory drugs (NSAIDs) are one method used to reduce inflammation and pain.

How NSAIDs work

NSAIDs block a group of enzymes called cyclooxygenases (COX), which produce prostaglandins. Prostaglandins are a type of hormone that can trigger inflammation and pain as part of the immune response.

There are two forms of COX, COX-1 and COX-2, which are more or less active in different parts of the body. COX-1 is more active in the stomach and kidneys, while COX-2 is active at the site of an immune reaction and is involved more dominantly in stimulating inflammation.

NSAIDs usually are prescribed as a first-line therapy for musculoskeletal sarcoidosis, in particular for Löfgren syndrome or arthritis-like symptoms, such as stiff, swollen, or painful joints. They also are prescribed to reduce fevers.

In many musculoskeletal sarcoidosis patients, NSAIDs are enough to control the disease without the use of stronger therapies such as corticosteroids or immune modulating therapies.

Types of NSAIDs

There are many types of NSAIDs available. Common examples include aspirin, ibuprofen, naproxen, and celecoxib. They vary based on whether they inhibit COX-1, COX-2, or both.

Ibuprofen and naproxen tend to inhibit both enzymes equally. Aspirin preferentially targets COX-1, whereas celecoxib is more specific to COX-2. Celecoxib also may be referred to as a COX-2 inhibitor.

Some NSAIDs such as ibuprofen and aspirin are available over-the-counter in lower doses and these should not be taken at the same time as prescription NSAIDs.

Other information

Common side effects of NSAIDs include heartburn, stomach pain, nausea, vomiting, diarrhea or constipation, gas, and feeling bloated.

NSAIDs that target COX-1 are more likely to cause gastrointestinal symptoms.

People taking NSAIDs in large doses or for a long period of time may have an increased risk of cardiovascular problems, stomach ulcers or bleeding, and impaired kidney function.


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