June 26, 2013
NSAIDs Risky Even in Short Term for Patients with
Heart Disease

Madrid, Spain—Cardiovascular risks increase almost immediately with the use of some nonsteroidal anti-inflammatory drugs (NSAIDS), yet the drugs continue to be prescribed for patients at risk for cardiovascular disease, according to a new study presented at EULAR 2013, the Annual Congress of the European League Against Rheumatism.

Study presenters noted that, according to published evidence, NSAIDS have significant cardiovascular implications for users, adding that mortality risk increased within a week of treatment for those who had a history of heart attack. NSAIDS are commonly prescribed for rheumatoid arthritis, musculoskeletal diseases, and other chronic pain-related conditions, and duration of usage can be long term, the authors noted.

“The side effect profile and safety of NSAIDs has been commonly reported, but little is known about treatment duration and its implications for cardiovascular risk,” commented Carl Orr, MD, from the Royal College of Surgeons in Dublin, Ireland. “These data demonstrate an immediate increase in the risk of death and MI, challenging the safety of even short-term use. The introduction of physician guidelines to assist safe prescribing of this class of drug is vital, and the only way to keep patient safety at the forefront of disease management.”

To reach those conclusions, researchers analyzed records of 10,000 patients registered with a large primary-care facility focusing on patients older than 50 years of age who had been prescribed NSAIDs for any duration and also had documented ischemic heart disease, diabetes mellitus, and/or hypertension. Looking at a 2-month period in late 2012, they found that 108 patients were prescribed NSAIDs and that 36% of them had established ischemic heart disease or risk factors for cardiovascular disease. Mean duration of treatment was 265 days, with 56% prescribed NSAIDs for longer than one month, and 15% for a year or longer. Diclofenac was the NSAID prescribed in 56% of cases reviewed.

Study authors called for better guidelines for prescribing NSAIDS, especially in patients with existing cardiovascular disease.

“We find it disconcerting that diclofenac was prescribed in 56% of cases and suggest that recommendations to switch to safer alternatives are a critical component of any physician guidelines,” Orr said.

U.S. Pharmacist Social Connect