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Wildhainweg 3, P.O. Box 8232, CH-3001 Berne Press and Information Office

Bern, 11. January 2011 (embargo: 12.01.11, 01.00 am)

Press Release

Side effects of non-steroidal anti-inflammatory drugs

Pain killers increase risk of heart attack
If you regularly take pain killers – even those available over the counter – you
often expose yourself to higher risks of heart attack and apoplexy. This is the
result of a meta-analysis of 31 clinical studies which was done as part of the
National Research Programme «Musculoskeletal Health – Chronic Pain» (NRP
53).

The most commonly used pain killers are non-steroidal anti-inflammatory drugs. They dull pain, lower fever and inhibit inflammations, but they also have some undesirable side effects and risks. These side effects have been re-evaluated by Peter Jüni’s research group at the University of Bern’s Institute for Social and Preventive Medicine. Their project forms part of the NRP 53. For their extensive network meta-analysis, which was recently published in the «British Medical Journal» (*), they used results from 31 clinical studies including data on seven different pain killers and 116,429 patients. The researchers conclude that some non-steroidal anti-inflammatory drugs increase the risk of heart attack and apoplexy considerably. «Due to their often underestimated cardiovascular risks, this class of pain killers should be used with caution,» says Sven Trelle, first author of the study. Up to four times higher cardiovascular mortality
The researchers analysed the side effects of Naproxen, Ibuprofen, Diclofenac, Celecoxib, Etoricoxib, Rofecoxib and Lumiracoxib. These drugs are commonly used to manage musculoskeletal pains of elderly patients who often also have cardiovascular problems. Without drugs, an average of 1% of these patients die per year. All analysed drugs are associated with a heightened risk of heart attack and apoplexy. The highest risk comes with the conventional over-the-counter drug Diclofenac and the COX-2 inhibitor Etoricoxib which was admitted to the Swiss market last year. In comparison to a placebo, the two drugs displayed a cardiovascular mortality rate that was four times higher. Naproxen offers the most favourable risk profile. This drug is, however, associated with considerable gastrointestinal side effects which often negatively affect its therapeutic uses. Both traditional as well as the newer so-called COX-2 selective pain killers (they only inhibit one of the enzymes involved in the inflammatory reaction and should theoretically act more specifically) raise cardiovascular mortality. «This shows,» says Trelle, «that different molecular properties do not always lead to different side effects.» To be used with caution
«Our results do not allow any inferences regarding the side effects of drugs that we didn’t analyse,» says Jüni. The only reason they did not extend their study to cover other non-steroidal anti-inflammatory drugs is the lack of reliable data relating to cardiovascular safety of other substances. «The lack of such data should not lead to the conclusion that other pain killers have no side effects,» Jüni warns. «All drugs of this class should be used with caution in patients with musculoskeletal pains.» (*) Sven Trelle, Stephan Reichenbach, Simon Wandel, Pius Hildebrand, Beatrice
Tschannen, Peter M. Villiger, Matthias Egger and Peter Jüni (2010).
Cardiovascular safety of non-steroidal anti-inflammatory drugs: a network meta-
analysis. British Medical Journal online: doi: 10.1136/bmj.c7086
(available as a PDF from the SNSF; E-mail: [email protected])
Contact:
Professor Peter Jüni
Institute for Social and Preventive Medicine
University of Bern
Finkenhubelweg 11
CH-3012 Bern
Phone:

National Research Programme "Musculoskeletal Health – Chronic Pain"
(NRP 53)
For a five-year period, ending in 2009, 26 research projects looked into the
musculoskeletal health of the Swiss population. Researchers examined the causes
of complaints, challenged existing therapies and developed new approaches to
maintain and restore the health of the musculoskeletal system.
www.nfp53.ch
The text of this press release is available at www.snf.ch > E > Media > Press releases

Source: http://www.nfp53.ch/files/download/MM_110112_NFP53_Schmerzmittel_Nebenwirkungen_e.pdf

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