A study of the longitudinal utilization and switching-patterns of non-steroidal anti-inflammatory drugs using a pharmacy based approach

Comparative cardiovascular safety of nonsteroidal anti‐inflammatory drugs in patients with hypertension: a population‐based cohort study

“…These differences may partially explain our neutral findings across these individual NSAIDs. The pattern of low-dose, short-term use of NSAIDs was also observed in three German, UK and French adult cohorts [46][47][48].…”

“…One early meta-analysis of RCTs, mainly conducted in arthritis patients, suggested that COX-2-selective NSAIDs, as a class, have a higher risk of MI than nonselective NSAIDs, with a hazard ratio (HR) of 1. 46 [95% confidence interval (CI) 1.02, 2.09] [12]. However, two large-scale, non-inferior RCTs in arthritis patients [13,14] and some active comparison observational studies in elderly patients or those hospitalized for coronary heart disease (CHD) [15][16][17][18] found no difference in cardiovascular risk when comparing individual COX-2-selective NSAIDs (celecoxib and etoricoxib) with individual nonselective NSAIDs (diclofenac, ibuprofen and naproxen).…”

Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data

“…6 7 Risk of acute myocardial infarction associated with NSAIDs should be further characterised by pooling population based observational studies since these better reflect how NSAIDs are used in practice. 8 We performed an individual patient data meta-analysis of studies from healthcare databases to determine the time course for risk of acute myocardial infarction and the effects of dose and of duration of continuous use for the main NSAIDs. The study was designed to capture the complex time varying nature of NSAID use.…”

Celecoxib, a cyclooxygenase-2 inhibitor, improved upper gastrointestinal lesions in rheumatoid arthritis patients as assessed by endoscopic evaluation

“…Thus, patients taking traditional NSAIDs experience various GI toxicities, ranging in severity from nausea and dyspepsia to hemorrhage and perforation, resulting in the administration of additional gastroprotective agents, namely, H 2 receptor antagonists, proton pump inhibitors (PPIs), or prostaglandin (PG) analogues (primarily misoprostol), or the discontinuation of NSAID therapy and substitution with other anti-inflammatory medication [9]. Published studies assessing NSAID utilization suggest a high level of therapeutic switching, commonly related to low tolerability or lack of efficacy [10][11][12].…”