A new analysis of the cardiovascular safety of NSAIDs (nonsteroidal anti-inflammatory drugs) shows that COX-2 (http://en.wikipedia.org/wiki/COX-2_inhibitor) specificity is no guide to risk, and suggests that only Naproxen has any net benefit for symptomatic treatment of musculoskeletal conditions.
The review of all major randomised trials comparing NSAIDs with other NSAIDs or placebo concluded that almost all NSAIDs had an unacceptable risk/benefit profile and that the OTC availability of NSAIDs such as ibuprofen and diclofenac should be reconsidered.
Published in the BMJ, the Swiss study of 31 trials of seven widely used NSAIDs found that only naproxen could be confidently expected not to increase the risk of MI by 30%. “Conversely, we are confident that several other drugs—ibuprofen, diclofenac, etoricoxib, and lumiracoxib—are associated with a risk increase of more than 30% on several cardiovascular outcomes,” the authors write.
They say the safety profile of individual NSAIDs varies considerably depending on the cardiovascular outcome. Rofecoxib (Vioxx) was associated with the highest risk of myocardial infraction, followed by lumiracoxib, whereas ibuprofen was associated with the highest risk of stroke followed by diclofenac. Etoricoxib and diclofenac were associated with the highest risk of cardiac death. The study authors say that while naproxen seems to be the safest analgesic in cardiovascular terms, this had to be weighed against its GI toxicity and the need for concomitant use of a PPI (proton pump inhibitors) in some patients. They suggest celecoxib 400 mg once daily as an alternative.
Did you know that there are very safe and very effective natural alternatives to these nasty drugs?
Do the natural anti-inflammatorieshave side effects? Yes: antioxidant, health building, wonderful effects!
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