Caution advised for NSAID arthritis treatment

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Non-steroidal anti-inflammatory drugs (NSAIDS) have been a mainstay of treatment for rheumatoid arthritis and other inflammatory musculoskeletal diseases. Such treatment is not without risk for some sufferers, however, says a new, preliminary study covered by MedPage Today.

People with rheumatoid arthritis have an elevated risk of cardiovascular disease, and NSAIDS have been shown to also increase this risk. Yet, the study found, in a review of 108 patients records in Dublin, 36 percent had a documented ischemic heart disease, or risk factors such as high blood pressure or diabetes.

The NSAID diclofenac was the drug prescribed in 56 percent of the cases examined. Some patients (56 percent) were given the drug for longer than one month, and 15 percent received it for a year or longer.

Dr. Carl Orr and colleagues from the Royal College of Surgeons in Ireland performed the case review. Dr. Orr commented It would be preferable to use disease-modifying anti-inflammatory drugs before resorting to NSAIDS.

In a further critique, he mentioned that it had previously been believed that short-term use of NSAIDS was safe, but that in a recent study of patients with recent heart attacks, use of diclofenac or ibuprofen (Advil) was linked to increased risk within just one week of treatment.

He also noted that NSAIDS should not be used in conjunction with methotrexate, which is a cornerstone of treatment.

ACSH s Dr. Gil Ross commented As a rheumatologist, I would take such cautions very seriously, especially if further research supports the data and conclusions in the current study. It is important to consider the patient s overall health when treating rheumatoid arthritis not simply the arthritis itself.