Common painkiller poses risk to heart health

Glen Mclaughlin
September 9, 2018

Diclofenac, a commonly used painkiller, was associated with an increased risk of major cardiovascular problems, including heart attacks and strokes, compared with no medication or other medication, according to a study in Denmark.

The study ran from 1996 to 2016, during which time researchers found that starting diclofenac use caused an increased risk of serious cardiac events taking place within 30 days of starting the substance; this compared to taking other common NSAIDs or acetaminophen.

Now a groundbreaking study of more than six million people, the biggest of its kind, has linked them to "major cardiovascular events". Do you use Diclofenac? Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs.

Diclofenac is the most commonly used non-steroidal anti-inflammatory drug (NSAID) in low, middle, and high income countries, and it is prescribed to millions of people in the United Kingdom every year. But the authors of a new study argue that diclofenac shouldn't be allowed as an over-the-counter drug, or at the very least, should be accompanied by appropriate warnings. These risks remained regardless of the diclofenac dose.

"Diclofenac poses a cardiovascular health risk compared with non-use, paracetamol use, and use of other traditional nonsteroidal anti-inflammatory drugs", explain the authors. Current concerns about the cardiovascular safety of NSAID use mean that such a trial would now be unethical, but regulators including the European Medicines Agency are still calling for the safety of diclofenac to be assessed.

A study carried out by researchers in Denmark looked at nearly 1,400,000 patients who were started on diclofenac between 1996 and 2016, as well as patients who were initiated on other types of NSAIDs and patients who weren't initiated on any NSAIDs.

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Researchers used Danish national registry data for more than 6.3 million adults over a ten-year period to emulate clinical trial conditions to test the risk of diclofenac against other painkillers.

The risk of gastrointestinal bleeding at 30 days increased 4.5-fold in patients who started diclofenac compared to those who didn't.

The results also suggested that although the absolute risks associated with diclofenac use were highest in individuals who already demonstrated high baseline cardiovascular risk, the relative risk was actually highest in people with the lowest baseline risk.

Researchers found that the increased risks applied to men and women of all ages and also those taking low doses of diclofenac.

"It is time to acknowledge the potential health risk of diclofenac and reduce its use", they wrote.

Other reports by MaliBehiribAe

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