02/06/2006

Pain drugs 'increase heart attack risk'

People taking two common painkillers regularly could be at increased risk of suffering a heart attack, a report has claimed.

The report, conducted by researchers from Oxford University and the University of Rome and published in the British Medical Journal, raised concerns that high doses of two forms of non-steroidal anti-inflammatory drug (NSAID) - ibuprofen and diclofenac - could increase the risk of suffering a heart attack.

Previously, concerns had been raised about the links between the use of the newer COX-2 inhibitors and an increased risk of heart attacks. One such drug, Vioxx, was taken off the market in 2004 due to concerns about increased heart attack risk.

The latest study performed a combined analysis of all the available randomised trials that compared a COX-2 inhibitor with placebo, or a COX-2 inhibitor with a traditional NSAID, and had recorded serious cardiovascular events.

The study found that, as expected, COX-2 inhibitors were associated with an increased risk of vascular events, mainly heart attacks. However, the researchers said that there was "insufficient data" to reliably assess whether these risks were dose dependent, or whether the risks might differ among aspirin and non-aspirin users.

However, the study also showed that high doses of diclofenac and ibuprofen, were associated with a similar increase in the risk of vascular events to COX-2 inhibitors. However, researchers also found that the risks of high doses of another NSAID, naproxen, were smaller.

However, the researchers said that the overall risk was small, with around three extra people out of every 1,000 taking an NSAID or COX-2 inhibitor having a heart attack each year.

The authors of the report recommended that very large randomised trials were needed in order to identify which anti-inflammatory drug regimens minimise serious cardiovascular and gastrointestinal problems.

(KMcA)

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