The slow titration ladder exists precisely to keep them tolerable
NSAIDs inhibit COX-2 and COX-1 and, decrease synovial inflammation in RA (Staczyk and Kowalski 2001)
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1 Environmental or metabolic stressors, including nutritional state, physical activity, hormonal regulation, and pathological conditions such as heart failure, cancer cachexia, and chronic liver disease, require appropriate fuel selection to maintain metabolic homeostasis
There are other anorectic hormones that instead work rapidly, signaling our brain on more of a meal-to-meal basis