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NSAIDs and heart failure link: PAGB highlights flaws

The PAGB has highlighted the limitations of a study published today in the BMJ that links non-steroidal anti-inflammatory drugs to an increased risk of heart failure.

John Smith, PAGB chief executive, said: “This observational study analysed prescriptiononly NSAIDs, used long-term by people with an average age of 77 years to treat conditions such as arthritis. Prescribed NSAIDs contain a higher dosage than medicines available over-the-counter (OTC), which the authors acknowledge would typically be used by younger people, at lower doses and for shorter durations than those prescribed."

The authors of the nested case-control study, carried out at the University of Milano-Bicocca in Italy, admit that it has several limitations. The study looked at real world data from four European countries (Netherlands, Italy, Germany and United Kingdom) and almost 10 million NSAID users without a history of heart failure. A total of 27 individual NSAIDs, including 23 traditional NSAIDs and four selective COX 2 inhibitors, were included in the analysis.

"The study does not provide data on absolute risk, therefore the probability of these people developing heart failure without the use of NSAIDs is unknown," said Mr Smith. “The authors also highlight that the risk of hospital admissions varies between the type of NSAID used and the dose taken. Furthermore, heart failure is often associated with other cardiovascular diseases which could mean that some of the people analysed were already at higher risk of heart failure prior to the study."

“If anyone has any concerns about an existing health condition, we would recommend they always speak to a pharmacist before taking any medicine to check for any potential drug interactions or health concerns.”







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