Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Differences in cardiovascular safety with non-steroidal anti-inflammatory drug therapy-A nationwide study in patients with osteoarthritis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. COVID-19 clinical trials: Ethical and scientific consequences of the RECOVERY trial results

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  2. Pharmacokinetics of Ferric bepectate - a new intravenous iron drug for treating iron deficiency

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Oral Immunosuppressive Treatment of Myasthenia Gravis in Denmark: A Nationwide Drug Utilization Study, 1996-2013

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. [Sar1, Ile4, Ile8]-angiotensin II Potentiates Insulin Receptor Signalling and Glycogen Synthesis in Hepatocytes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Temporal changes in the incidence of infective endocarditis in Denmark 1997-2017: A nationwide study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Work exposure and associated risk of hospitalisation with pneumonia and influenza: A nationwide study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Switching from Vitamin K Antagonist to Dabigatran in Atrial Fibrillation: Differences According to Dose

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Vitamin K antagonists vs. direct oral anticoagulants after transcatheter aortic valve implantation in atrial fibrillation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Carlo Alberto Barcella
  • Morten Lamberts
  • Patricia McGettigan
  • Emil Loldrup Fosbøl
  • Jesper Lindhardsen
  • Christian Torp-Pedersen
  • Gunnar Hilmar Gislason
  • Anne-Marie Schjerning Olsen
Vis graf over relationer

Osteoarthritis (OA) and the non-steroidal anti-inflammatory drugs (NSAIDs) used to relieve OA-associated pain have been linked independently to increased cardiovascular risk. We examined the risk of cardiovascular events associated with NSAID use in patients with OA. We employed linked nationwide administrative registers to examine NSAID use between 1996 and 2015 by Danish patients with OA aged ≥18 years. Using adjusted Cox proportional hazard analyses, we calculated the risk of the composite outcome of cardiovascular death, non-fatal myocardial infarction and non-fatal ischaemic stroke/TIA, and of each outcome separately, up to 5 years after OA diagnosis. Of 533 502 patients included, 64.3% received NSAIDs and 38 226 (7.2%) experienced a cardiovascular event during follow-up. Compared with non-use, all NSAIDs were associated with increased risk of the composite outcome: hazard ratio (HR) for rofecoxib, 1.90 (95% confidence interval, 1.74-2.08); celecoxib, 1.47 (1.34-1.62); diclofenac, 1.44 (1.36-1.54); ibuprofen, 1.20 (1.15-1.25); and naproxen, 1.20 (1.04-1.39). Similar results were seen for each outcome separately. When celecoxib was used as reference, ibuprofen (HRs: 0.81 [CI: 0.74-0.90]) and naproxen (HRs: 0.81 [0.68-0.97]) exhibited a lower cardiovascular risk, even when low doses were compared. Low-dose naproxen and ibuprofen were associated with the lowest risks of the composite outcome compared to no NSAID use: HRs: 1.12 (1.07-1.19) and 1.16 (0.92-1.42), respectively. In patients with OA, we found significant differences in cardiovascular risk among NSAIDs. Naproxen and ibuprofen appeared to be safer compared to celecoxib, also when we examined equivalent low doses. In terms of cardiovascular safety, naproxen and ibuprofen, at the lowest effective doses, may be the preferred first choices among patients with OA needing pain relief.

OriginalsprogEngelsk
TidsskriftBasic & clinical pharmacology & toxicology
Vol/bind124
Udgave nummer5
Sider (fra-til)629-641
Antal sider13
ISSN1742-7843
DOI
StatusUdgivet - maj 2019

ID: 56526302