Une nouvelle étude démontre le risque cardio des AINS hormis le Naproxen

Last Update: Friday, June 10, 2005. 3:10pm (AEST)

Study suggests cardiac risk from painkillers

New research to be published on Saturday points an accusing finger at widely prescribed types of anti-inflammatories, saying it found evidence that some of the drugs fuel the risk of first-time heart attack.

The medications, called non-steroidal anti-inflammatory drugs (NSAIDs), are commonly prescribed to ease arthritis and muscle ache but some doctors are beset with concerns about their safety.

In the biggest study of its kind, British researchers compared the drug regimen among 9,218 people in England and Wales who had suffered their first heart attack.

They took into account the person's age, obesity, smoking habits, whether the patient was taking aspirin or had heart disease, for these are factors that could distort the picture.

Significant increase
The researchers found that the risk of a first-time heart attack was "significantly increased" for people who had taken certain NSAIDs in the three months before the cardiac event, when compared with those who had not taken any NSAID in the previous three years.

For the over-the-counter NSAID ibuprofen, the increased risk was 24 per cent and for diclofenac, it was 55 per cent.

The figures were also bad for a controversial newer generation of NSAID called COX-2 inhibitors, designed by the pharmaceutical industry with the goal of providing pain relief for arthritis but avoiding gastric side-effects.

Those prescribed the drug celecoxib (marketed as Celebrex) or rofecoxib (Vioxx) were at a 21 per cent and 32 per cent increased risk of a first-time heart attack respectively, when compared with people who had not taken the drugs in the previous three years, the study found.

Vioxx was voluntarily withdrawn from the market last September by its maker Merck after it was linked to a higher incidence of cardiac problems among some some patients.

Scrutiny
Since then, the safety of the remaining drugs in the COX-2 inhibitor class has come under close scrutiny.

The United States now requires them to carry labels warning of the risk of heart problems and gastrointestinal bleedings.

The study, which appears in the weekly British Medical Journal (BMJ), says patients should not stop taking the drugs involved, and adds there could be data flaws in the study.

The drug naproxen did not have any increased risk.

But it said, further investigation into these treatments is needed, especially as they are widely prescribed to elderly people, a section of the population that is most at risk of heart attack.

Source : http://www.abc.net.au/news/newsitems/200506/s1389444.htm