Saturday, October 1, 2011

Relative safety of non-steroidal anti-inflammatory medications

A recent study has made some important observations on the cardiovascular risk of different NSAIDs. The summary of this study is presented below.

For those patients with normal kidney function, who are not on anticoagulants, who do not have other contraindications, we commonly suggest naproxen (Aleve) used according to the manufacturer's specifications.

"Data from a study published online in the journal PLoS Medicine suggest that, among widely used non-steroidal anti-inflammatory drugs (NSAIDs), naproxen and low-dose ibuprofen are the least likely to increase cardiovascular risk. The authors conducted a systematic review of 30 case-control studies covering 184,946 cardiovascular events, and 21 cohort studies that described outcomes in more than 2.7 million exposed individuals. Of the most extensively studied drugs, the highest overall risks were seen with rofecoxib and diclofenac, and the lowest with ibuprofen and naproxen. In a sub-set of studies, risk was elevated with low doses of rofecoxib, celecoxib, and diclofenac, with risk increasing with higher doses. Ibuprofen risk was seen only with higher doses, while naproxen was risk-neutral at all doses."


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