Common painkillers called NSAIDs can increase the risks of heart problems, according to a newly-published study. NSAIDs are a class of drugs that includes popular over-the-counter painkillers like Aleve, Motrin and Advil, as well as prescription <"http://www.yourlawyer.com/topics/overview/cox-ii_inhibitors">COX-2 Inhibitors like Celebrex. The study appears in the British Medical Journal.
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 study authors conclude: “Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms. Cardiovascular risk needs to be taken into account when prescribing any non-steroidal anti-inflammatory drug.”
An accompanying editorial says these cardiovascular risks are worrying because many patients have both cardiovascular disease and musculoskeletal disease, and suggests that it is time for an evaluation of a broader range of alternatives.
In 2004, the COX-2 inhibitor rofecoxib (Vioxx) was withdrawn from the market after a trial found that the drug increased the risk of cardiovascular disease.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.
The authors of this latest study maintain that it provides the best available evidence on the safety of this class of drugs.