What do All Anti-Inflammatory Drugs Have in Common?

What do All Anti-Inflammatory Drugs Have in Common?  And What in the world is this diagram trying to explain?

According to a recently published research paper, from the British Medical Journal in 2011, new data show that all major, non-steroid anti-inflammatory drugs (NSAIDs) have cardiovascular risks.  Investigators evaluating available evidence report they have found little to suggest that any of the investigated options are safe.

Non-steroidal anti-inflammatory drugs (NSAIDs) have been the cornerstone of pain management in patients with osteoarthritis and other painful conditions. In the United States an estimated 5% of all visits to a doctor are related to prescriptions of non-steroidal anti-inflammatory drugs and they are among the most commonly used drugs.  Researchers looking at 31 clinical trials and over 115, 000 patients concluded that conditions including myocardial infarction, hemorrhagic or ischemic stroke; cardiovascular death, (low output failure, fatal arrhythmia, pulmonary embolism)  and even death of unknown or any cause is more probable in people taking therapeutic doses of NSAIDS. 

The researchers state, “In conclusion, the options for the treatment of chronic musculoskeletal pain are limited and patients and clinicians need to be aware that cardiovascular risk needs to be taken into account when prescribing.”

Of all the NSAIDs, naproxen seemed least harmful in this study. However, according to Dr. Peter Juni, one of the study’s authors, due to stomach and gastrointestinal damage, "With naproxen, we tend to need a proton pump inhibitor to protect the stomach.  This is far from ideal."

In an upcoming post, I will get back to dietary factors that can promote inflammation.  Control of such factors can reduce inflammation in a manner that may reduce the need for NSAIDs.