VTE risk with NSAIDs not equal

Tuesday, 22 Mar 2016

Some NSAIDs are associated with a higher risk of venous thromboembolism than others, reveals a study in people with knee osteoarthritis.

According to the population-based case-control study the risk among current NSAID users was highest with diclofenac [OR 1.63 (95% CI: 1.53, 1.74)], followed by ibuprofen [OR=1.49 (95% CI: 1.38, 1.62)], meloxicam [OR=1.29 (95% CI: 1.11, 1.50)] and then coxibs (celecoxib, OR=1.30 (95% CI: 1.11, 1.51); rofecoxib, OR=1.44 (95% CI: 1.18, 1.76)]

The research team observed no increase in VTE risk among naproxen users [OR=1.00 (95% CI: 0.89, 1.12)].

“While there is no consensus on how NSAIDs influence thrombotic events, one common hypothesis is that NSAIDs cause an imbalance between prostacyclin and thromboxane, triggering an unopposed expression of thromboxane due to the selective inhibition of COX-2,” the researchers wrote in Rheumatology.

Diclofenac, ibuprofen, celecoxib and meloxicam should be used with caution in people with VTE risk factors, they concluded.

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