NSAIDs Raise Heart Risks, New Study Finds

The world’s most popular painkillers, NSAIDs—nonsteroidal anti-inflammatory drugs—which are used by millions, have been linked to heart risks in another study. The study results appear, this week, in the journal PLoS Medicine.

NSAIDS, such as Advil, Motrin, and Aleve have a long history links to increased risks of adverse events and we have long written about other research that has linked NSAIDs such aspirin, ibuprofen, and prescription medications that include COX-2 inhibitors including Celebrex (generic: celecoxib), to increased risks for heart failure, death, and even erectile dysfunction (ED).

Now, said The Globe and Mail, NSAIDs have been connected in another study to increased risks for serious cardiovascular issues that include the increased risk for heart attack in some patients. The team revealed that the drug, diclofenac, which poses similar risks as the now-banned Vioxx, was linked to the most heart risks—similar to those seen in Vioxx. Diclofenac is marketed under a wide array of brand names, including Voltaren and is considered the most popular NSAID in the world, said The Globe and Mail.

As we’ve often written, in 2004, the COX-2 inhibitor Vioxx (rofecoxib) was withdrawn from the market after a trial found that the drug increased risks for cardiovascular disease. Since, there has been much debate about the cardiovascular safety of COX-2 inhibitors and traditional NSAIDs.

The study should induce clinicians to avoid riskier drugs, said the study’s co-author, David Henry, who was referring to diclofenac. “Doctors and patients need to be aware of the evidence,” said Dr. Henry, president and CEO of Toronto’s Institute for Clinical Evaluative Sciences, wrote the Globe and Mail.

The team reviewed data from prior observational studies, which the team said was a high-quality method of gathering information about NSAID effects over time, said the Globe and Mail. These studies enabled the team to review real-world effects of many NSAIDs. The team was particularly concerned with diclofenac risks and hope the study will help lead to the drug’s phase-out. “[We] got a risk we couldn’t distinguish from Vioxx, which was taken off the market,” Dr. Henry said. “Regulatory agencies don’t seem to be acting against [diclofenac],” he added, wrote The Globe and Mail.

Some other NSAIDs that have not been clinically scrutinized, appeared to also pose significant risks for cardiovascular events, pointing to the need for more research, said The Globe and Mail. For instance, said the team, etoricoxib, etodolac (sold under a number of names, including Apo-Etodolac), and indomethacin (sold under a number of names, including Apo-Indomethacin), are on the market in various—but not necessarily, all—countries, might warrant additional study.

Andreas Laupacis, executive director of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital in Toronto, pointed out that NSAIDs have probably been connected to heart issues for decades, but the risks are only being seen since Vioxx was pulled, reported the Globe and Mail. Because NSAIDs have never been studied in the same way that Vioxx was ultimately researched, some drugs’ risks may have gone unnoticed, Laupacis, said, added The Globe and Mail.

Meanwhile, we recently wrote that long-term use of the drugs has been linked, in a Harvard research report, to increased risks for developing kidney cancer. NSAIDs have been linked to the reduction of some cancers, so this particular study provides some opposing insight. The study revealed a link between regular use of nonaspirin NSAIDs and renal cell cancer, resulting in a 51 percent increase in the relative risk for the disease. The risk was 19 percent lower if the medications were used for less than four years; however, the risk for renal cell cancer rose to 36 percent in people using nonaspirin NSAIDs regularly for four to 10 years, increasing nearly three-fold in those who used the drugs in excess of a decade.

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