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NSAIDs for arthritis seem to be okay for the heart


Patients with inflammatory polyarthritis who take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen do not appear to have an excess risk of dying from cardiovascular disease, new research shows. Inflammatory polyarthritis is a form of rheumatoid arthritis (RA) involving two or more joints.

The finding that patients with inflammatory polyarthritis/RA who were NSAID users did not have increased risk of dying from cardiovascular disease "provides some reassurance for RA patients who are dependent on NSAIDs for symptom control," Dr. Nick J. Goodson told Reuters Health.

Goodson, from Liverpool University, UK and colleagues explored whether NSAID use was associated with heart-related death in 923 patients newly diagnosed with inflammatory polyarthritis.

The average length of NSAID use was 4 years, and patients were followed a median of about 10 years, during which time 85 subjects died of cardiovascular disease.

NSAID use at the start of the study was associated with a 46 percent lower risk of dying from cardiovascular disease, the researchers found. Having ever used an NSAID during follow-up was also significantly associated with a reduced risk of cardiovascular death.

Increasing duration of NSAID exposure did not enhance the reduction in cardiac-related mortality, the investigators say, but avoidance of NSAID use was associated with an increase in cardiovascular death.

The investigators admit that the findings run counter to the literature relating to NSAID use in the general population.

"Despite the detailed longitudinal data collection, we feel that there may be unmeasured confounding that might explain our findings," Goodson said.

"One possible factor is that physicians' prescribing of NSAIDs may have been influenced by factors such as frailty that are difficult to quantify. This may have led to channeling of NSAIDs away from frailer patients," they surmise.

SOURCE: Annals of the Rheumatic Diseases, March 2009.