New analysis of the cardiovascular risks of common non-steroidal anti-inflammatory drugs

September 27, 2011, Public Library of Science

An updated study published in this week's PLoS Medicine gives some new information on the cardiovascular risks of non-steroidal anti-inflammatory drugs (NSAIDs) and suggests that among these commonly used drugs, naproxen and low dose ibuprofen are least likely to increase cardiovascular risk whereas diclofenac, even in doses available without prescription, elevates risk.

Using only (30 case-control studies and 21 cohort studies) because have only reported small numbers of , the authors, Patricia McGettigan (Hull York Medical School, Hull, UK), and David Henry (Institute for Clinical Evaluative Sciences, Toronto, Canada) also found that the new NSAID, , has a high risk of cardiovascular events similar to that of drugs that have been withdrawn because of safety concerns and that new evidence on of indomethacin, an older drug, casts doubt on its continued clinical use.

The authors say: "the large sizes of the studies reviewed here, the presence of consistent dose-response relationships, and general agreement with the results of randomised trials give us confidence in the results." They add: "In our view, the results are sufficiently robust to inform clinical and regulatory decisions."

This study highlights the importance of adequately assessing drug safety in clinical trials and in an editorial the editors write: "debates continue about the best ways to meaningfully synthesize and interpret data on the possible harmful effects of drugs – for example, how passive surveillance systems (spontaneous reports of suspected adverse reactions) should be improved, whether new drugs should go through a phased launch process with enhanced safety evaluation, and the appropriateness of risk mitigation strategies for drugs with safety concerns."

The editors conclude: "However, these challenges should not detract investigators, regulators, and patients from demanding a higher safety standard for approved drugs. Higher standards will require both greater transparency – in revealing what studies are being conducted and what data have been generated – and greater willingness of funders to support new studies specifically addressing drug safety."

Explore further: Short term use of painkillers could be dangerous to heart patients

More information: McGettigan P, Henry D (2011) Cardiovascular Risk with Non-Steroidal Anti-Inflammatory Drugs: Systematic Review of Population-Based Controlled Observational Studies. PLoS Med 8(9): e1001098. doi:10.1371/journal.pmed.1001098

Related Stories

Short term use of painkillers could be dangerous to heart patients

May 9, 2011
Even short-term use of some painkillers could be dangerous for people who've had a heart attack, according to research published in Circulation: Journal of the American Heart Association.

Recommended for you

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

Place of residence linked to heart failure risk

January 9, 2018
Location. Location. Location.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.