The Medicines and Healthcare products Regulatory Agency (MHRA) has highlighted the results of an international study led by the Hull York Medical School that aimed to assess the cardiovascular risks of non-steroidal anti-inflammatory drugs (NSAIDs).
This study included data from more than 2,700,000 individuals included in 51 studies. The data set allowed analysis of 184,946 cardiovascular events. The relative risks of cardiovascular events for several NSAIDs were calculated as follows:
- Rofecoxib 1.45 (95% CI 1.33 - 1.59)
- Diclofenac 1.40 (1.27 - 1.55)
- Ibuprofen 1.18 (1.11 - 1.25)
- Naproxen 1.09 (1.02 - 1.16)
- Celecoxib 1.26 (1.09 - 1.47) - from a data subset
- Etoricoxib 2.05 (1.45 - 2.88) - from a data subset
- Etodolac 1.55 (1.28 - 1.87) - from a data subset
- Indomethacin 1.30 (1.19 - 1.41) - from a data subset
The authors conclude that, "among widely used NSAIDs, naproxen and low-dose ibuprofen are least likely to increase cardiovascular risk". They also note that the data for indomethacin casts doubt on its continued use.
Action: As noted by the MHRA, the findings presented by this study are not new but the relative risk information may prove useful. Current advice remains the same; Use an NSAID with the lowest risk, for the shortest time and at the lowest dose necessary to control symptoms.