BMJ  2006;332:895-898 (15 April), doi:10.1136/bmj.332.7546.895

Practice

Practice pointer

Understanding the NSAID related risk of vascular events

Harald E Vonkeman, rheumatologist1, Jacobus R B J Brouwers, professor of pharmacotherapeutics2, Mart A F J van de Laar, professor of rheumatology1

1 Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente Hospital and University of Twente, Enschede, Netherlands, 2 Groningen University Institute for Drug Exploration and Groningen Research Institute of Pharmacy, Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, Groningen, Netherlands

Correspondence to: H E Vonkeman H.Vonkeman@ziekenhuis-mst.nl

The first 150 words of the full text of this article appear below.

Concern is growing about an increased risk of thrombotic events (including myocardial infarction and stroke) during the use of non-steroidal anti-inflammatory drugs (NSAIDs), in particular the so called selective cyclo-oxygenase-2 (COX 2) inhibitors. Although clinical trials give conflicting results with respect to the incidence of vascular events, increasing evidence shows that a class effect might exist for selective COX 2 inhibitors. Even before the massive introduction of selective COX 2 inhibitors, observational studies showed that the use of NSAIDs causes congestive heart failure in elderly patients.1 2 Conversely, the discontinuation of NSAIDs has also been associated with increased risk of myocardial infarction, especially in the first several weeks after stopping chronic NSAID treatment.3

Many different mechanisms could explain the different effects of classic NSAIDs and selective COX 2 inhibitors in relation to thrombotic vascular events. In this review we link biochemical facts concerning NSAIDs and COX inhibitors with data from clinical . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

Relevant Article

Non-steroidal anti-inflammatory drugs after hip replacement
Fraser Birrell and Stefan Lohmander
BMJ 2006 333: 507-508. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Wieser, F., Cohen, M., Gaeddert, A., Yu, J., Burks-Wicks, C., Berga, S. L., Taylor, R. N. (2007). Evolution of medical treatment for endometriosis: back to the roots?. Hum Reprod Update 13: 487-499 [Abstract] [Full text]  
  • Birrell, F., Lohmander, S. (2006). Non-steroidal anti-inflammatory drugs after hip replacement.. BMJ 333: 507-508 [Full text]  

Rapid Responses:

Read all Rapid Responses

COX 2 Drugs - An alternative point of view.
Grant J Haldane
bmj.com, 27 Apr 2006 [Full text]
Re: COX 2 Drugs - An alternative point of view.
Harald E. Vonkeman, et al.
bmj.com, 10 May 2006 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ