When these reports come out, I always thing of the charges the GCC. brought against Jesper Jensen and Waren Gage; That they were misleading the public telling them "they should avoid drugs if possible".
Study spells out heart attack risk posed by painkillers
· Problem found with patients on high doses
· Authors stress danger is minimal in everyday use
Alok Jha, science correspondent
Friday June 2, 2006
The Guardian
Common painkillers such as ibuprofen and diclofenac can double the risk of heart attack, according to a new study. The increased risk only occurs with high doses and leads to attacks in an extra three people per thousand compared with those not taking the drugs.
Colin Baigent, an epidemiologist at Oxford University, who led the research, said people should not be unduly panicked by the findings, which relate to the highest doses given by doctors in extreme cases. "The rate is three heart attacks in every 1,000 patients treated for a year," he said. "For a person who is unable to move unless they take these drugs, they may be willing to accept that risk if [the drug] is giving them back their life."
Dr Baigent said that until now, doctors had been confused over the best way to prescribe anti-inflammatory painkillers, but the new study "supersedes all the previous work that has been done in this area. We have looked at all the evidence that has ever been done and our report is hopefully going to help doctors assess these drugs."
Anti-inflammatory drugs have been known to cause heart problems in the past. Vioxx, which is part of a group of new-generation anti-inflammatory drugs known as cox-2 inhibitors, was banned in 2004 after it was shown that patients on the drug were more than twice as likely to have heart attacks as those not taking it.
For the new study, scientists combined the results of 138 separate trials which compared cox-2 inhibitor drugs with a placebo or a cox-2 inhibitor with traditional non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac. The data represented 140,000 patients and is published today in the British Medical Journal.
The study confirmed cox-2 inhibitors doubled the risk of an attack but found NSAIDs had a similar effect. When all "vascular events" – heart attacks, stroke or vascular disease – were taken together the risk increased by 40% on the drugs.
Dr Baigent said a high dose was considered to be "about twice what the normal person would take. People who are popping these for the odd headache, the risks to them are minimal. We need to get these risks in perspective, to give the information to doctors and patients so they can make sensible decisions."
Professor Peter Weissberg, medical director of the British Heart Foundation, said the increase in risk identified by the study was small. Doctors and patients should look for alternatives to anti-inflammatory drugs where possible, he said, and keep use of NSAIDs to a minimum, particularly in patients with known heart disease. Further studies were needed into which NSAIDs were safest.
