Tuesday, June 14, 2005

Pain killers

'Ibuprofen can raise risk of heart attack', says the UK Daily Mail, reporting on new research suggesting that a number of different painkillers used for the treatment of arthritic pain, including ibuprofen, can induce heart attacks. The study looked at 9,218 patients attending 367 doctors' surgeries across the UK from 2000 to 2004. The rates of first heart attacks among those taking rofecoxib (aka Vioxx), celecoxib (Celebrex), ibuprofen and other painkillers were compared with a group of controls. There was an increased risk for users of a number of these drugs. The chance of a first heart attack was 24 per cent higher for ibuprofen users, 21 per cent higher for celecoxib and 32 per cent higher for rofecoxib. Professor Julia Hippisley-Cox, the lead researcher, told the Mail: 'Given the high prevalence of the use of these drugs in elderly people and the increased risk of heart attack with age, there is cause for concern' - although she stressed that patients should not stop taking their medication.

There is no suggestion that popping a couple of ibuprofen for your headache is a problem. The patients in this study were largely of pensionable age, taking painkillers every day to cope with arthritis. These are patients for whom the health problems of old age, like heart disease, would be expected.

Moreover, the increased risks involved are small. For ibuprofen, the study suggests that there would be an extra heart attack for roughly every 1,000 patients - and even for the much-demonised Vioxx, the extra risk seems to be one heart attack for every 695 patients.

These small risks have to be set against the pain of arthritis itself, and the small risk of gastro-intestinal bleeding that seems to be higher among older drugs like aspirin and ibuprofen compared to the more modern preparations. No drug is a 'magic bullet' that does exactly what it is intended to do and nothing else - even the safest drugs can cause harm in a small minority of patients. In fact, it would be fair to say that a drug without side effects is a placebo.

Painkillers make life bearable for millions of people, from the severely arthritic to the severely hung-over. If negative publicity encourages patients to stop using these drugs, the harm caused is likely to be greater than any small risk incurred from continued use. Keep taking the tablets.

spiked-central | Panic | Don't panic

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