Current Use of Nonsteroidal Antiinflammatory Drugs and the Risk of Acute Myocardial Infarction

Fischer, Lorenz; Schlienger, Raymond G.; Matter, Christian M.; Jick, Hershel; Meier, Christoph

doi:10.1592/phco.25.4.503.61021

Cited by 60 publications

(53 citation statements)

References 44 publications

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“…On the basis of the available evidence, the Advisory Committee of the Food and Drug Administration (FDA) reported that the benefits of celecoxib outweighed its risks. In subsequent epidemiological analysis that investigated whether CV events were related to NSAID usage, conventional NSAIDs were found to elevate CV risk, while the risk due to celecoxib was identified in only 1 out of 17 studies (table 6[64,65,66,67,68,69,70,71,72,73,74,75,76], table 7[77,78,79,80,81,82,83,84,85,86,87,88,89,90,91]). Thus, the FDA judged that the CV risk is not related to the class effect of selective COX-2 inhibitors.…”

Section: Safety Of Celecoxibmentioning

confidence: 99%

Efficacy and Safety of the Selective Cyclooxygenase-2 Inhibitor Celecoxib in the Treatment of Rheumatoid Arthritis and Osteoarthritis in Japan

Sakamoto

Soen

2010

Digestion

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Background/Aims: Gastrointestinal (GI) disorders are common adverse reactions of nonsteroidal anti-inflammatory drugs (NSAIDs). Loxoprofen is a representative NSAID widely used in East Asia. A selective cyclooxygenase-2 inhibitor, celecoxib, was introduced in Japan in 2007. In this study, we aimed to compare the efficacy and safety of celecoxib with those of loxoprofen in Japanese patients. Methods: We analyzed the data from 12 clinical studies conducted in Japan. These data of Japanese patients were compared with those of the patients in the West that had been published after 2000. Results: The efficacy of celecoxib as an analgesic was comparable to that of loxoprofen, whereas serious GI events, including symptomatic ulcers, were significantly less frequent with celecoxib than with loxoprofen in Japanese patients with rheumatoid arthritis (RA) and osteoarthritis (OA) (p = 0.039). These results were consistent with the findings of the studies conducted in the West. The incidence of serious cardiovascular events was 0.1% in 2,398 subjects on celecoxib, which was not statistically different from the incidence in subjects on loxoprofen (0.3%; p = 0.3404) and those on placebo (0.2%); this result was also consistent with the data of the studies conducted in the West. Conclusion: The analgesic activity of celecoxib, which was used for the treatment of RA, OA, and low back pain, was comparable to that of loxoprofen, and celecoxib was safer in terms of GI injury often caused by other nonselective NSAIDs.

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Section: Safety Of Celecoxibmentioning

confidence: 99%

Efficacy and Safety of the Selective Cyclooxygenase-2 Inhibitor Celecoxib in the Treatment of Rheumatoid Arthritis and Osteoarthritis in Japan

Sakamoto

Soen

2010

Digestion

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“…The authors cite prior documentation regarding the common use of low-dose aspirin after MI, which is guideline-recommended care. Because aspirin may mitigate the excess risk of NSAIDs, 9 the reported excess risk of death and recurrent MI for the use of NSAID alone may be substantially underestimated. 10 However, it is possible that patients discontinued aspirin while they took NSAIDs to reduce the risk of gastrointestinal adverse effects or because they (or their doctor) thought the NSAID had similar cardioprotective effects.…”

Section: Article P 2906mentioning

confidence: 99%

What Price Pain Relief?

Hochman

Shah

2006

Circulation

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“…Other studies showed diferent results. A retrospective study on 42,611 patients, including 8688 cases of MI, found that patients treated with aspirin and any NSAID had a lower risk for MI than the ones not taking aspirin and NSAIDs [43]. Another study on 22,071 apparently healthy patients showed that regular but not intermitent use of NSAIDs inhibits the clinical beneits of aspirin [44].…”

Section: Antithromboticsmentioning

confidence: 99%

Adverse Effects and Drug Interactions of the Non‐Steroidal Anti‐Inflammatory Drugs

Voștinaru¹

2017

Nonsteroidal Anti-Inflammatory Drugs

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The aim of this chapter is to increase the awareness of health-care professionals concerning potential adverse efects and drug interactions of non-steroidal anti-inlammatory drugs (NSAIDs), which are among the most widely prescribed medicines, globally. They have a variety of clinical applications due to their anti-inlammatory, analgesic, antipyretic, or antithrombotic efect, but these drugs are not entirely innocuous, since they could increase the risk of gastrointestinal and cardiovascular complications. Furthermore, the drugs from this class have the potential of altering the pharmacokinetics of associated drugs, and also pharmacodynamic interactions have been reported. The clinical signiicance, mechanisms, and epidemiology of the adverse efects and drug interactions of NSAIDs are presented in this chapter. Prevention strategies for particularly high-risk groups of patients are also exposed. Detailed and up-to-date information regarding the adverse efects and drug interactions of NSAIDs are needed for all healthcare professionals in order to maximize eicacy in treating various illnesses while minimizing the risks for the patients.

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Current Use of Nonsteroidal Antiinflammatory Drugs and the Risk of Acute Myocardial Infarction

Abstract: Our results provide additional evidence that the risk of first-time acute myocardial infarction during current use of NSAIDs is not materially altered. We found no evidence for a reduced cardioprotective effect of aspirin with concomitant NSAID use.

Cited by 60 publications

References 44 publications

Efficacy and Safety of the Selective Cyclooxygenase-2 Inhibitor Celecoxib in the Treatment of Rheumatoid Arthritis and Osteoarthritis in Japan

Efficacy and Safety of the Selective Cyclooxygenase-2 Inhibitor Celecoxib in the Treatment of Rheumatoid Arthritis and Osteoarthritis in Japan

What Price Pain Relief?

Adverse Effects and Drug Interactions of the Non‐Steroidal Anti‐Inflammatory Drugs

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