Saturday, 17 November, 2018

Painkiller diclofenac linked to increased heart risks in study

Diclofenac could increase heart failure Diclofenac could increase heart failure
Anna Jefferson | 09 September, 2018, 04:59

Researchers discovered within the first 30 days of taking the common painkiller, some patients experienced several cardiovascular events such as a flutter, heart failure, heart attack, or ischemic stroke. But given the cardiovascular and gastrointestinal risks, there is little justification for starting a diclofenac treatment before testing other traditional NSAIDs, "the researchers concluded".

Now a groundbreaking study of more than six million people, the biggest of its kind, has linked them to "major cardiovascular events". Diclofenac is a traditional NSAID that has similar selectivity for cyclo-oxygenase-2 (COX 2) as COX 2 inhibitors, but the cardiovascular risks of diclofenac in comparison with other traditional NSAIDs have not been investigated through a randomized controlled trial.

Diclofenac is a NSAID used for treatment of pain and inflammation with the brand names Voltaren, Cataflam and Zipsor.

Using national population and prescription drug registries, they were able to look at the medical records of over 6 million Danish adults from 1996 to 2016.

Diclofenac is a component which is frequently found in painkillers which are usually used to alleviate back pain, arthritis, and sciatica.

More clear warnings should be given about the risks of diclofenac, say researchers who found a higher risk of heart attack and stroke associated with its use. Diclofenac should not be available over the counter, and when prescribed, should be accompanied by an appropriate front package warning about its potential risks'.

The risk of gastrointestinal bleeding at 30 days increased 4.5-fold in patients who started diclofenac compared to those who didn't.

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The authors point out that, although the relative risk was increased, the absolute risk remained low for the individual patient.

Now, a team from Denmark has uncovered evidence that people who use diclofenac, one of the most commonly used NSAIDs and one often available without a prescription, experience significantly more serious adverse events than those taking other NSAIDs or paracetamol (aka acetaminophen).

The researchers said that despite the potential side effects, treatment with NSAIDs may be worthwhile for improving the quality of life of patients suffering from pain and inflammation.

However, they add: "This is an observational study, so no firm conclusions can be drawn about cause and effect".

People who have suffered heart failure, heart disease or a stroke should stop using it completely.

"It's time to acknowledge the potential health risk of diclofenac and to reduce its use", write Morten Schmidt, M.D., Ph.D., registrar, Henrik Toft Sørensen, M.D., Ph.D., clinical professor and chair, and Lars Pedersen, Ph.D., professor, department of clinical epidemiology, Aarhus University.

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