When it comes to the gastrointestinal adverse effects, especially stomach bleeding, not all anti-inflammatory drugs (NSAIDs) are equal, according to a new study.
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“Balancing between the NSAID safest and most effective always has its advantages and disadvantages,” he told Reuters Health co-authored a new study, Dr. Luis A. García Rodríguez, the Spanish Center Pharmacoepidemologic Research in Madrid.
For that reason, he said, people have to use these drugs should choose the one with the lowest risk of gastrointestinal and use the shortest period possible and to the lowest effective dose.
Stomach bleeding is a risk factor for all NSAIDs, the team said Garcia Rodriguez in the journal Arthritis and Rheumatism.
But the comparable risks of individual anti-inflammatory such as ibuprofen, and the new NSAIDs, called COX-2 inhibitors such as celecoxib, sold under the name Celebrex, “are in discussion.”
These drugs were designed to reduce gastrointestinal side effects, but have other problems. For example, in 2004 was withdrawn Vioxx (rofecoxib) for causing heart problems.
To compare the gastrointestinal risks of all NSAIDs, the researchers reviewed the medical literature from 2000 to 2008 and identified nine studies.
All enrolled patients hospitalized or referred to a specialist for gastrointestinal bleeding or lesions in the stomach lining.
Previous studies have shown that the risk of these complications without prescription NSAID consumption was low, with one case per 1000 people per year in the general population.
But the risk increases with age and in people with ulcers. For example, a man of 70 years with an ulcer have a 4 percent risk of stomach bleeding or injuries at some point.
They found that traditional NSAIDs rose four times the risk of gastrointestinal bleeding or injury, ie a 16 percent annual risk to the hypothetical patient 70.
And the COX-2 was nearly double that risk, raising at least 8 percent annual risk in that patient.
The use of traditional NSAIDs was less risky in low doses (eg up to 1,200 milligrams of ibuprofen, which is the maximum daily use without a prescription). This dose, equivalent or similar drugs double the risk of developing complications at online pharmacy.
But higher doses (between 1,200 and 2,400 milligrams of ibuprofen per day) quintupled the risk of bleeding or injury to the stomach lining. The risks increased immediately when patients began taking the drugs.
SOURCE: Arthritis and Rheumatism, online February 22, 2010.
