con2my:
Risk of acute myocardial #infarction with #NSAIDs in real world use: bayesian meta-analysis of individual patient data
http://www.bmj.com/content/357/bmj.j1909
A cohort of 446 763 individuals including 61 460 with acute myocardial infarction was acquired. Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations.
Conclusions All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses
Risk of acute myocardial #infarction with #NSAIDs in real world use: bayesian meta-analysis of individual patient data
http://www.bmj.com/content/357/bmj.j1909
A cohort of 446 763 individuals including 61 460 with acute myocardial infarction was acquired. Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations.
Conclusions All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses
The BMJ
Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data
Objective To characterise the determinants, time course, and risks of acute myocardial infarction associated with use of oral non-steroidal anti-inflammatory drugs (NSAIDs).
Design Systematic review followed by a one stage bayesian individual patient data…
Design Systematic review followed by a one stage bayesian individual patient data…
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Effect of #anticoagulants and #NSAIDs on accuracy of faecal immunochemical tests (#FITs) in colorectal cancer screening: a systematic review and meta-analysis
https://gut.bmj.com/content/early/2018/06/05/gutjnl-2018-316344
Our literature search identified 2022 records, of which 8 studies were included. A total of 3563 participants with a positive FIT were included. Use of OACs was associated with a PPVAN of 37.6% (95% CI 33.9 to 41.4) compared with 40.3% (95% CI 38.5 to 42.1) for non-users (p=0.75). Pooled PPVAN in aspirin/NSAID users was 38.2% (95% CI 33.8 to 42.9) compared with 39.4% (95% CI 37.5 to 41.3) for non-users (p=0.59).
Conclusion FIT accuracy is not affected by OACs and aspirin/NSAIDs use. Based on the current literature, withdrawal of OACs or NSAIDs before FIT screening is not recommended. Future studies should focus on duration of use, dosage and classes of drugs in association with accuracy of FIT to conduct more specific guideline recommendations.
Effect of #anticoagulants and #NSAIDs on accuracy of faecal immunochemical tests (#FITs) in colorectal cancer screening: a systematic review and meta-analysis
https://gut.bmj.com/content/early/2018/06/05/gutjnl-2018-316344
Our literature search identified 2022 records, of which 8 studies were included. A total of 3563 participants with a positive FIT were included. Use of OACs was associated with a PPVAN of 37.6% (95% CI 33.9 to 41.4) compared with 40.3% (95% CI 38.5 to 42.1) for non-users (p=0.75). Pooled PPVAN in aspirin/NSAID users was 38.2% (95% CI 33.8 to 42.9) compared with 39.4% (95% CI 37.5 to 41.3) for non-users (p=0.59).
Conclusion FIT accuracy is not affected by OACs and aspirin/NSAIDs use. Based on the current literature, withdrawal of OACs or NSAIDs before FIT screening is not recommended. Future studies should focus on duration of use, dosage and classes of drugs in association with accuracy of FIT to conduct more specific guideline recommendations.
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Duration of Symptom Relief and Early Trajectory of Adverse Events for Oral #NSAIDs in Knee #Osteoarthritis: A Systematic Review and Meta‐analysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23884
NSAIDs demonstrated moderate, statistically significant effects on pain that peaked at 2 weeks (SMD ‐0.43 ‐0.48, ‐0.38), but the magnitude of the effects decreased over time. The results for function were similar. The incidence of GI AEs was significantly higher in NSAID users than placebo users as early as 4 weeks (RR 1.38 1.21, 1.57). The incidence of CV AEs in NSAID users was not significantly different from placebo. Most GI and CV AEs were transient and of minor severity.
Conclusion
NSAIDs produced significant pain and function improvements that peaked at 2 weeks but decreased over time. The incidence of minor GI and CV AEs consistently rose, reaching significance as early as 4 weeks. Clinicians should weigh the durability of efficacy with the early onset of minor AEs along with patient tolerability and preferences when formulating an NSAID regimen.
Duration of Symptom Relief and Early Trajectory of Adverse Events for Oral #NSAIDs in Knee #Osteoarthritis: A Systematic Review and Meta‐analysis
https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.23884
NSAIDs demonstrated moderate, statistically significant effects on pain that peaked at 2 weeks (SMD ‐0.43 ‐0.48, ‐0.38), but the magnitude of the effects decreased over time. The results for function were similar. The incidence of GI AEs was significantly higher in NSAID users than placebo users as early as 4 weeks (RR 1.38 1.21, 1.57). The incidence of CV AEs in NSAID users was not significantly different from placebo. Most GI and CV AEs were transient and of minor severity.
Conclusion
NSAIDs produced significant pain and function improvements that peaked at 2 weeks but decreased over time. The incidence of minor GI and CV AEs consistently rose, reaching significance as early as 4 weeks. Clinicians should weigh the durability of efficacy with the early onset of minor AEs along with patient tolerability and preferences when formulating an NSAID regimen.
Nonsteroidal Anti-Inflammatory Drugs (#NSAIDs): Drug Safety Communication – Avoid Use of NSAIDs in #Pregnancy at 20 Weeks or Later
https://2medical.news/2020/10/25/nonsteroidal-anti-inflammatory-drugs-nsaids-drug-safety-communication-avoid-use-of-nsaids-in-pregnancy-at-20-weeks-or-later/
FDA is warning that use of NSAIDs around 20 weeks or later in pregnancy may cause rare but serious kidney problems in an unborn baby. This can lead to low levels of amniotic fluid surrounding the baby and possible complications. For prescription NSAIDs, FDA is requiring changes to the prescribing information to describe the risk of kidney problems in unborn babies that result in low …
https://2medical.news/2020/10/25/nonsteroidal-anti-inflammatory-drugs-nsaids-drug-safety-communication-avoid-use-of-nsaids-in-pregnancy-at-20-weeks-or-later/
FDA is warning that use of NSAIDs around 20 weeks or later in pregnancy may cause rare but serious kidney problems in an unborn baby. This can lead to low levels of amniotic fluid surrounding the baby and possible complications. For prescription NSAIDs, FDA is requiring changes to the prescribing information to describe the risk of kidney problems in unborn babies that result in low …