When all these simulated trials was averaged out, people who took diclofenac were 50 per cent more likely to have cardiovascular problems in the first 30 days after use than were people who took nothing.
A new Danish study finds some painkillers may be bad for your heart. Current concerns about the cardiovascular safety of NSAID use mean that such a trial would now be unethical, but regulators including the European Medicines Agency are still calling for the safety of diclofenac to be assessed.
As it is used mostly to treat inflammations and pains, diclofenac, which is a non-steroidal anti-inflammatory drug, also known as NSAID, is broadly consumed all over the world.
However, due to ethical concerns, these risks can not be evaluated in clinical trials. The gastrointestinal and cardiovascular risks associated with the treatment, however, does not justify initiating diclofenac treatment before other traditional NSAIDs.
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Diclofenac initiators were also at 20% increased risk compared to patients taking ibuprofen or paracetamol, and at 30% increased risk compared to those taking naproxen. Diclofenac should not be available over the counter, and when prescribed, should be accompanied by an appropriate front package warning about its potential risks'.
Now, a new study focuses on one NSAID in particular: diclofenac.
During the study period, the researchers examined the cardiovascular risks of taking up diclofenac and compared them with the risks of starting paracetamol, ibuprofen, or naproxen. Then, the researchers followed and studied these individuals for the next two decades from 1996 to 2006.
Diclofenac, a widely used worldwide drug with anti-inflammatory and analgesic properties, is associated with an increased risk of heart attack, stroke and other serious cardiovascular problems, so its use should be done with moderation rather than for a long time.
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A 2017 study showed that the risk of heart among those who use NSAIDs is more pronounced when the drug is taken in high daily doses. In other words, the higher the risk of heart problems when the patients started taking the drug, the higher the risk of actually developing heart problems over the course of the treatment.
They used an open registry of over 6.3 million adults in Denmark, with patients split into low, moderate and high baseline cardiovascular risk.
"Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects", they write.
And as it was an observational study, no firm conclusions can be drawn about cause and effect.
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Researchers concluded: "Diclofenac poses a cardiovascular health risk compared with non-use, paracetamol use, and use of other traditional non-steroidal anti-inflammatory drugs".