Cardiovascular and Gastrointestinal Risks Associated with Selective and Non-selective Nsaids
From: Sint Maartenskliniek, afd. Farmacie, Hengstdal 3, 6522 JV Nijmegen. b.vandenbemt@maartenskliniek.nl
Nederlands tijdschrift voor geneeskunde
- Publish Date: May 2007
- ISSN: 0028-2162
- Volume: 151
- Issue: 19
- Pages: 1062-7
- Medium: Print
- Language:
- Citation (JAMA): van den Bemt B J F, Benraad H B, Rasker J J, et al. Cardiovascular and Gastrointestinal Risks Associated with Selective and Non-selective Nsaids. May 2007;151:1062-7
Abstract
There has been much discussion regarding the cardiovascular and gastrointestinal safety of traditional and COX-2 selective NSAIDs. The national and international guidelines differ in their recommendations. Selective COX-2 inhibitors seem to have a diminished risk for severe gastrointestinal complications in the short-term, but the long-term benefit has not yet been proven. In various studies, COX-2 selective NSAIDs have been associated with an increased risk of cardiovascular complications. This connection has been clearly demonstrated only for rofecoxib. Celecoxib seems to lead to an increased risk only at high dosages. However, more patients will have to be followed for a longer period to confirm these results. There is insufficient evidence that the COX-2 selective agents lead to more frequent cardiovascular complications than the traditional NSAIDs. In patients with an increased risk of gastrointestinal complications and no cardiovascular risk, there is no preference for either COX-2 selective NSAIDs or the combination of traditional NSAIDs and a proton pump inhibitor. If dyspepsia develops during the use of a traditional NSAID, then it seems more effective to add a proton-pump inhibitor to the traditional NSAID rather than replacing it by a COX-2 selective NSAID.
Mesh Headings (Keywords): Anti-Inflammatory Agents, Non-Steroidal, Cardiovascular Diseases, Cyclooxygenase 2 Inhibitors, Dyspepsia, Gastrointestinal Diseases, Humans, Risk Factors
Check for Full Text / PubMed Unique Identifier (PMID): 17552414
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