Non-steroidal anti-inflammatory drugs (NSAIDs) are the second most widely used class of analgesics in France, after paracetamol. Some NSAIDs are available over the counter (OTC), without a prescription, on the advice of a pharmacist. NSAIDs have recently been the subject of safety alerts from France's Agence nationale de s & eacute;curit & eacute; du m & eacute;dicament et des produits de sant & eacute; (ANSM), highlighting a risk of worsening certain bacterial infections. This signal has not been confirmed by the European Medicines Agency (EMA) although a "risk of complications due to masking of symptoms of infection" has not been ruled out. These divergent messages can be confusing for healthcare professionals. This literature review, based on an analysis of nearly 200 scientific publications, considers the place of NSAIDs in the OTC management of migraine, tension headaches, postoperative analgesia, acute musculoskeletal and joint pain, dysmenorrhea, viral respiratory infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and their toxicity. The role of the pharmacist in dispensing NSAIDs without a prescription is also addressed. NSAIDs offer rapid and effective pain management in a context of increasingly challenging access to care. Their safety profile is reassuring and generally well established but could be strengthened by conducting an ad hoc study to rule on the safety signal issued by the ANSM definitively. Pharmacists have the knowledge and tools to ensure the safe dispensing and rational use of NSAIDs, with or without a prescription. The introduction of risk minimization measures, such as decision-support tools, could enable further progress in ensuring the safe dispensing of OTC NSAIDs. (c) 2024 The Author(s). Published by Elsevier Masson SAS on behalf of Societe franc,aise de pharmacologie et de therapeutique. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Les anti-inflammatoires non stéroïdiens (AINS) sont la deuxième classe d’antalgiques la plus utilisée en France derrière le paracétamol. Certains AINS sont disponibles sans ordonnance, sur conseil du pharmacien, donc à « prescription médicale facultative » (PMF). Les AINS ont récemment fait l’objet d’alertes de sécurité de la part de l’Agence nationale de sécurité du médicament et des produits de santé (ANSM) mettant en avant un risque d’aggravation de certaines infections bactériennes. Ce signal n’a pas été confirmé par Agence européenne du médicament (EMA) sans exclure un « risque de complications dues au masquage des symptômes d’infection ». Ces messages divergeant peuvent être source de confusions pour les professionnels de santé. Cette revue de la littérature, basée sur l’analyse de près de 200 publications scientifiques, examine la place des AINS dans la prise en charge en PMF de la migraine, des céphalées de tension, de l’analgésie postopératoire, des douleurs aiguës musculosquelettiques et articulaires, des dysménorrhées, des infections respiratoires virales, y compris le coronavirus 2 du syndrome respiratoire aigu sévère (SARS-CoV-2) ainsi que leur toxicité. Elle s’intéresse également au rôle du pharmacien dans la dispensation des AINS sans ordonnance. Les AINS permettent une prise en charge rapide et efficace de la douleur dans un contexte de difficulté croissante d’accès aux soins. Leur profil de sécurité est rassurant et globalement bien établi, mais pourrait être renforcé par la conduite d’une étude ad hoc pour statuer définitivement sur le signal de sécurité émanent de l’ANSM. Les pharmaciens disposent des connaissances et des outils pour sécuriser la dispensation et veiller à l’utilisation rationnelle des AINS avec ou sans ordonnance. La mise en place de mesures de minimisation de risque telles que des outils d’aide à la décision pourraient permettre d’aller plus loin dans la sécurisation de leur dispensation en PMF.

Concomitant administration of multiple drugs frequently causes severe pharmacokinetic or pharmacodynamic drug–drug interactions (DDIs) resulting in the possibility of enhanced toxicity and/or treatment failure. The activity of cytochrome P450 (CYP) 3A4 and P-glycoprotein (P-gp), a drug efflux pump sharing localization and substrate affinities with CYP3A4, is a critical determinant of drug clearance, interindividual variability in drug disposition and clinical efficacy, and appears to be involved in the mechanism of numerous clinically relevant DDIs, including those involving dexamethasone. The recent increase in the use of high doses of dexamethasone during the COVID-19 pandemic have emphasized the need for better knowledge of the clinical significance of drug–drug interactions involving dexamethasone in the clinical setting. We therefore aimed to review the already published evidence for various DDIs involving dexamethasone in vitro in cell culture systems and in vivo in animal models and humans.

Diagnosis, prognostic assessment, and monitoring disease activity in patients with large vessel vasculitis (LVV) can be challenging. Early recognition of LVV and treatment adaptation is essential because vascular complications (aneurysm, dilatations, ischemic complications) or treatment related side effects can occur frequently in these patients. 18-fluorodeoxyglucose positron emission tomography/computed tomography (2-[18F]FDG-PET/CT) is increasingly used to diagnose, follow, and evaluate treatment response in LVV. In this review, we aimed to summarize the current evidence on the value of 2-[18F]FDG-PET/CT for diagnosis, follow, and treatment monitoring in LVV.