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Despite guideline restrictions, NSAID prescribing continues to rise, highlighting a gap between regulation and clinical practice.
A new real-world analysis has uncovered significant trends in the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) in Italy, raising concerns about compliance with the Italian Medicines Agency (Agenzia italiana del farmaco, AIFA) Note 66 guidelines. The study led by Valentina Perrone et al. evaluated NSAID utilization patterns between 2019 and 2022 and revealed increasing prescription rates, a shift in the most commonly used molecules, and potential inappropriate use beyond approved medical indications.
Researchers analyzed data collected from administrative health databases covering approximately 9.1 million Italian citizens. All individuals receiving at least one NSAID prescription between 2019 and 2022 were included. The study assessed patient demographics, frequency of NSAID prescriptions over time, most prescribed NSAID molecules, and drug consumption measured in defined daily doses (DDD) per 1,000 inhabitants per day.
Key findings
NSAID use increased steadily from 2019 to 2022.
The top prescribed NSAIDs are depicted in Table 1:
Notably, while most NSAIDs were administered at low-to-medium doses, ibuprofen (600 mg) was used at high dosage in 80% of prescriptions, raising safety considerations.
Patient Characteristics & Prescribing Patterns
Researchers concluded that NSAIDs may be over-prescribed or used outside AIFA Note 66-approved clinical indications, especially given the younger-than-expected patient demographic and limited association with chronic rheumatologic or oncologic conditions. The findings emphasize the requisition for:
As NSAIDs are linked with potential gastrointestinal, renal, and cardiovascular adverse effects—particularly at higher doses and prolonged use—experts emphasize optimizing pain management strategies in Italy to ascertain safety and cost-effectiveness.
Advances in Therapy
An Up-to-Date Description of the Use of Non-steroidal Anti-inflammatory Drugs (NSAIDs) in Italy: Evidence from Real Clinical Practice
Valentina Perrone et al.
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