Killer Painkillers?

Since Vioxx (Rofecoxib) was withdrawn and reports linking Celebrex (Celecoxib) to increased risk of heart attack and strokes came out last year, painkillers have continually been reaping nothing but bad publicity.

BACKGROUNDER: In practice, the most common complaint encountered by doctors is pain (headache, muscle ache, back pain, etc.), and the most common medications dispensed are the so-called COX-1 and COX-2 inhibitors, and the NSAIDs (non-steroidal anti-inflammatory drugs).

Pain is an interesting subject. Almost everyone has it. And almost everyone has taken a painkiller or two, or even more in his or her respective lifetimes. No one is exempted. We can't bear pain in our lives.

Now, here comes the clincher...the June 11 issue of the BMJ carried a report saying that popular NSAIDS like Ibufrofen and Diclofenac do elevate the risk of....hold your breath--- heart attack.

Popular NSAIDs include Ibuprofen, sold by Britain's Boots Group PLC as Nurofen and the US' Wyeth as Advil. Diclofenac, is sold by Switzerland's Novartis AG as Voltaren while Naproxen issold by Roche Holding AG and Bayer AG. They are prescribed to relieve inflammation and pain for patients with rheumatoid and osteoarthritis.

Nine million people with arthritis were yesterday left in a dilemma as ibuprofen, a painkiller which has long been considered one of the safest drugs on the market, was linked with heart attacks.

The news will dismay those who depend on drugs to reduce the stiffening in joints, alleviate the pain and allow them to lead a normal life.

The question mark over ibuprofen, of which Nurofen is one of the best known brands, and the other less well-known non-steroidal anti-inflammatories (NSAIDS) follows on the heels of the crisis over a newer class of medicines used for the same purpose.

[Guardian Unlimited, June 10 2005]

Read the full BMJ report here.

While the news sounds scary and alarming, don't panic.....yet. The study design of that report was a case-control study. As such, it is an observational study rather than a randomized clinical trial. The latter is a more accurate study than the former. Confused about scientific studies? Here's a helpful article that might help lessen your perplexity.

My opinion is that you can still take your NSAIDs for your acute and chronic aches. But to be safe, and because of new reports coming out like the one above, it is best to consult your personal physician about any possible heart condition you might have. Results from medical studies should always be treated with caution. The best option for patients is not to take matters on their hands alone, but to have a serious talk about these matters with their physician.