An emerging study has found that popular pain killers in the drug class of Nonsteroidal anti-inflammatory drugs (NSAIDs) increase heart attack and stroke risks, said Arthritis Today. NSAIDs include popular over-the-counter painkillers like Aleve, Motrin, Advil, aspirin, and ibuprofen, as well as prescription COX-2 Inhibitors like Celebrex (generic: celecoxib.
Doctors say that the finding concerning NSAID side effects is significant to those with chronic conditions since these patients could already be at an increased risk for cardiac problems, said Arthritis Today.
“The main finding is that we have found surprisingly large signals for most of the NSAIDs for all except naproxen. There’s a two- to four-fold increase in myocardial infarction, stroke, or cardiovascular deaths,” explains study author Peter Jüni, MD, quoted Arthritis Today. Dr. Jüni heads the division of clinical epidemiology and biostatistics at the Institute of Social and Preventive Medicine at the University of Bern in Switzerland. “We were surprised the signals were so high,” added Dr. Jüni.
In 2004, the COX-2 inhibitor rofecoxib (Vioxx) was withdrawn from the market after a trial found that the drug increased the risk of cardiovascular disease. Since then, there has been much debate about the cardiovascular safety of COX-2 inhibitors and traditional NSAIDs, which several studies have not been able to resolve. NSAIDs are the most popular medication, with five percent of all physician visits in the U.S. involving a prescription for an NSAID, said Arthritis Today. The team sought to determine if the Drug Side Effects seen in Vioxx are also seen in NSAIDs.
In conducting the study, Swiss researchers performed a comprehensive analysis of all randomized controlled trials comparing any NSAID with other NSAIDs or placebo. They included 31 trials and 116,429 patients taking seven different drugs “naproxen (Aleve), ibuprofen (Motrin and Advil), diclofenac, celecoxib (Celebrex), etoricoxib, rofecoxib (Vioxx), lumiracoxib” or placebo to provide a more reliable estimate of the cardiovascular risks of these drugs than previous studies.
In 29 trials there were a total of 554 heart attacks; in 26 trials there were 377 strokes, and in 28 trials there were 676 deaths. While the absolute risk of cardiovascular problems among people taking painkillers was low, the researchers did find that, relative to placebo, the drugs carried important risks.
For instance, compared with placebo, rofecoxib and lumiracoxib were associated with twice the risk of heart attack, while ibuprofen was associated with more than three times the risk of stroke. Etoricoxib and diclofenac were associated with the highest (around four times) risk of cardiovascular death. Naproxen appeared least harmful in terms of cardiovascular safety among the seven analyzed preparations.
The team noted that many people with arthritis and chronic inflammatory conditions have an increased risk for NSAIDs heart attack and stroke, but that this demographic also relies on NSAIDs, wrote Arthritis Today. Ideally, it would be best to take only one or two weeks and then discuss with doctors other alternatives, Dr. Jani said, quoted Arthritis Today. If they have a lot of pain and lost weight and still have problems, it may be surgical interventions are needed, he added.
More on NSAIDs and various side effects:
NSAID Use in Pregnancy: Dangers and Legal Recourse
