Thursday, September 09, 2010


NSAIDs ( Non-steroidal anti-inflammatory drugs ) are pain killers that we all use every now and then for those occasional troublesome bone pains and muscle pains. I was using it for a while for my left hip pains from 2005-2009. Then we became concerned that NSAIDs may be associated with an increase risk of heart attacks, which seemed to have happened in those at risk of heart attacks ( the elderly with chronic joint pains ). This worry was initially sparked by VIOXX, which incidentally was a COX2 inhibitor and not a true NSAID. Anyway, VIOXX is history, and they have all been removed.
Now I learn that a paper presented by the Danish workers at the just ended European Society of Cardiology Congress in Stockholm, showed that the incidental taking of NSAID in healthy individuals is associated with an increase in the risk of strokes. Please note that this study was in normal individuals. Led by Dr Gunnar Gislarson, they studied normal individuals in Denmark ( about half a million of them ). They were able to find this " healthy individuals because in the Danish Healthcare system, they have health records of the whole population. Dr Gislarson and team looked into all individuals who were 10 years or older, who had no hospital admission in the last two years, without any prescription for chronic illnesses like hypertension and diabetes, for the last two years, and who had any prescription for use of NSAID. They then looked at the health records to see the incidence of strokes in these people. They found that those who had taken some NSAID, who were " normal " had an increase incidence of strokes. Whose with the diclofenacs ( locally they are voltaren and cataflam ) and least with ibuprofen. The risk also seemed to be dose related. The higher the dose, the greater the risk.
This paper is important because, many " healthy " individuals take NSAID for all kinds of aches and pains, and NSAID is available over the counter ( no need for prescription ). If these agents can cause strokes, then we may have to lobby the government to take these agents off the OTC ( over the counter ) list.
Obviously, this is an epidermiological study and is not confirmatory, but it certainly makes us sit up and take note. NSAIDs can be dangerous and should not be used simply.
Only take drugs when you have to, when the benefit outweighs the risk.

1 comment:

Hanani said...

i am a medical student and enjoy reading through your blog. thanks for the medical updates!