Naproxen and cardiac safety during the use of nonsteroidal anti-inflammatory drugs Review article
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Published:
Jun 30, 2020
Keywords:
non-steroidal anti-inflammatory drugs, naproxen, cardiovascular complications
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Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used all over the world to treat pain and inflammatory diseases. In recent years, the widespread use of oral NSAIDs has been questioned due to the appearance of significant gastrointestinal and cardiovascular adverse events. NSAIDs are non-homogeneous group of drugs and there are significant differences between them in respect to mechanism of action and risk for gastrointestinal and cardiovascular complications. Some of non-selective NSAIDs have been withdrawn from the market despite high gastroenterological safety, due to their adverse effect on cardiovascular outcome. It has resulted in numerous studies on the cardiovascular safety of others NSAIDs. In many studies naproxen and celecoxib were found to be safe over ibuprofen and diclofenac in patients with elevated cardiovascular risk. Concomitant use of naproxen with acetylsalicylic acid has been also shown to maintain the cardio-protective effects of the latter. Appropriate treatment with NSAIDs should be preceded by careful clinical assessment of the patients and the choice of the appropriate NSAID.
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How to Cite
Lewandowski , J. (2020). Naproxen and cardiac safety during the use of nonsteroidal anti-inflammatory drugs. Medycyna Faktow (J EBM), 13(2(47), 180-187. https://doi.org/10.24292/01.MF.0220.6
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References
1. Singh G. Gastrointestinal complications of prescription and over-the-counter nonsteroidal anti-inflammatory drugs: a view from the ARAMIS database. Arthritis, Rheumatism, and Aging Medical Information System. Am J Ther. 2000; 7(2): 115-21.
2. Conaghan PG. A turbulent decade for NSAIDs: update on current concepts of classification, epidemiology, comparative efficacy, and toxicity. Rheumatol Int. 2012; 32(6): 1491-502.
3. Jones R. Nonsteroidal anti-inflammatory drug prescribing: past, present, and future. Am J Med. 2001; 110(1A): 4S-7S.
4. Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971; 231(25): 232-5.
5. Vane JR, Botting RM. Mechanism of action of nonsteroidal anti-inflammatory drugs. Am J Med. 1998; 104(3A): 2S-8S; discussion 21S-2S.
6. Snowden S, Nelson R. The effects of nonsteroidal anti-inflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011; 19(4): 184-91.
7. Mukherjee D, Nissen SE, Topol EJ. Risk of cardiovascular events associated with selective COX-2 inhibitors. JAMA. 2001; 286(8): 954-9.
8. Bombardier C, Laine L, Reicin A et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med. 2000; 343(21): 1520-8, 2 p following 8.
9. Silverstein FE, Faich G, Goldstein JL et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. JAMA. 2000; 284(10): 1247-55.
10. Johnson AG. NSAIDs and increased blood pressure. What is the clinical significance? Drug Saf. 1997; 17(5): 277-89.
11. Ruschitzka F, Borer JS, Krum H et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION- ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. Eur Heart J. 2017; 38(44): 3282-92.
12. Sowers JR, White WB, Pitt B et al. The Effects of cyclooxygenase-2 inhibitors and nonsteroidal anti-inflammatory therapy on 24-hour blood pressure in patients with hypertension, osteoarthritis, and type 2 diabetes mellitus. Arch Intern Med. 2005; 165(2): 161-8.
13. Johnson AG, Nguyen TV, Day RO. Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Ann Intern Med. 1994; 121(4): 289-300.
14. Kearney PM, Baigent C, Godwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006; 332(7553): 1302-8.
15. Rahme E, Pilote L, LeLorier J. Association between naproxen use and protection against acute myocardial infarction. Arch Intern Med. 2002; 162(10): 1111-5.
16. Watson DJ, Rhodes T, Cai B et al. Lower risk of thromboembolic cardiovascular events with naproxen among patients with rheumatoid arthritis. Arch Intern Med. 2002; 162(10): 1105-10.
17. Schjerning Olsen AM, Fosbol EL, Lindhardsen J et al. Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study. Circulation. 2011; 123(20): 2226-35.
18. Olsen AM, Fosbol EL, Lindhardsen J et al. Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study. PLoS One. 2013; 8(1): e54309.
19. McGettigan P, Henry D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med. 2011; 8(9): e1001098.
20. Fosbol EL, Gislason GH, Jacobsen S et al. Risk of myocardial infarction and death associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) among healthy individuals: a nationwide cohort study. Clin Pharmacol Ther. 2009; 85(2): 190-7.
21. Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013; 382(9894): 769-79.
22. Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med. 1989; 321(3): 129-35.
23. Antithrombotic Trialists Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002; 324(7329): 71-86.
24. Li X, Fries S, Li R et al. Differential impairment of aspirin-dependent platelet cyclooxygenase acetylation by nonsteroidal antiinflammatory drugs. Proc Natl Acad Sci USA. 2014; 111(47): 16830-5.
25. Catella-Lawson F, Reilly MP, Kapoor SC et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001; 345(25): 1809-17.
26. MacDonald TM, Wei L. Effect of ibuprofen on cardioprotective effect of aspirin. Lancet. 2003; 361(9357): 573-4.
27. Hohlfeld T, Saxena A, Schror K. High on treatment platelet reactivity against aspirin by non-steroidal anti-inflammatory drugs – pharmacological mechanisms and clinical relevance. Thromb Haemost. 2013; 109(5): 825-33.
28. Alqahtani Z, Jamali F. Clinical Outcomes of Aspirin Interaction with Other Non-Steroidal Anti-Inflammatory Drugs: A Systematic Review. J Pharm Pharm Sci. 2018; 21(1s): 29854.
29. Capone ML, Tacconelli S, Sciulli MG et al. Clinical pharmacology of platelet, monocyte, and vascular cyclooxygenase inhibition by naproxen and low-dose aspirin in healthy subjects. Circulation. 2004; 109(12): 1468-71.
30. Kurth T, Glynn RJ, Walker AM et al. Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal antiinflammatory drugs. Circulation. 2003; 108(10): 1191-5.
31. Burmester G, Lanas A, Biasucci L et al. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. Ann Rheum Dis. 2011; 70(5): 818-22.
32. Scarpignato C, Lanas A, Blandizzi C et al. Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC Med. 2015; 13: 55.
33. Samborski W, Filipiak KJ, Kaczmarczyk J et al. Niesteroidowe leki przeciwzapalne a powikłania sercowo-naczyniowe i gastroenterologiczne – algorytm wyboru. Choroby Serca i Naczyń. 2016; 13(4): 257-64.
34. Piepoli MF, Hoes AW, Agewall S et al. [2016 European Guidelines on cardiovascular disease prevention in clinical practice]. Kardiol Pol. 2016; 74(9): 821-936.
35. Trelle S, Reichenbach S, Wandel S et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011; 342: c7086. https://doi.org/10.1136/bmj.c7086.
2. Conaghan PG. A turbulent decade for NSAIDs: update on current concepts of classification, epidemiology, comparative efficacy, and toxicity. Rheumatol Int. 2012; 32(6): 1491-502.
3. Jones R. Nonsteroidal anti-inflammatory drug prescribing: past, present, and future. Am J Med. 2001; 110(1A): 4S-7S.
4. Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971; 231(25): 232-5.
5. Vane JR, Botting RM. Mechanism of action of nonsteroidal anti-inflammatory drugs. Am J Med. 1998; 104(3A): 2S-8S; discussion 21S-2S.
6. Snowden S, Nelson R. The effects of nonsteroidal anti-inflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011; 19(4): 184-91.
7. Mukherjee D, Nissen SE, Topol EJ. Risk of cardiovascular events associated with selective COX-2 inhibitors. JAMA. 2001; 286(8): 954-9.
8. Bombardier C, Laine L, Reicin A et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med. 2000; 343(21): 1520-8, 2 p following 8.
9. Silverstein FE, Faich G, Goldstein JL et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. JAMA. 2000; 284(10): 1247-55.
10. Johnson AG. NSAIDs and increased blood pressure. What is the clinical significance? Drug Saf. 1997; 17(5): 277-89.
11. Ruschitzka F, Borer JS, Krum H et al. Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION- ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. Eur Heart J. 2017; 38(44): 3282-92.
12. Sowers JR, White WB, Pitt B et al. The Effects of cyclooxygenase-2 inhibitors and nonsteroidal anti-inflammatory therapy on 24-hour blood pressure in patients with hypertension, osteoarthritis, and type 2 diabetes mellitus. Arch Intern Med. 2005; 165(2): 161-8.
13. Johnson AG, Nguyen TV, Day RO. Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Ann Intern Med. 1994; 121(4): 289-300.
14. Kearney PM, Baigent C, Godwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006; 332(7553): 1302-8.
15. Rahme E, Pilote L, LeLorier J. Association between naproxen use and protection against acute myocardial infarction. Arch Intern Med. 2002; 162(10): 1111-5.
16. Watson DJ, Rhodes T, Cai B et al. Lower risk of thromboembolic cardiovascular events with naproxen among patients with rheumatoid arthritis. Arch Intern Med. 2002; 162(10): 1105-10.
17. Schjerning Olsen AM, Fosbol EL, Lindhardsen J et al. Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study. Circulation. 2011; 123(20): 2226-35.
18. Olsen AM, Fosbol EL, Lindhardsen J et al. Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study. PLoS One. 2013; 8(1): e54309.
19. McGettigan P, Henry D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med. 2011; 8(9): e1001098.
20. Fosbol EL, Gislason GH, Jacobsen S et al. Risk of myocardial infarction and death associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) among healthy individuals: a nationwide cohort study. Clin Pharmacol Ther. 2009; 85(2): 190-7.
21. Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013; 382(9894): 769-79.
22. Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med. 1989; 321(3): 129-35.
23. Antithrombotic Trialists Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002; 324(7329): 71-86.
24. Li X, Fries S, Li R et al. Differential impairment of aspirin-dependent platelet cyclooxygenase acetylation by nonsteroidal antiinflammatory drugs. Proc Natl Acad Sci USA. 2014; 111(47): 16830-5.
25. Catella-Lawson F, Reilly MP, Kapoor SC et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001; 345(25): 1809-17.
26. MacDonald TM, Wei L. Effect of ibuprofen on cardioprotective effect of aspirin. Lancet. 2003; 361(9357): 573-4.
27. Hohlfeld T, Saxena A, Schror K. High on treatment platelet reactivity against aspirin by non-steroidal anti-inflammatory drugs – pharmacological mechanisms and clinical relevance. Thromb Haemost. 2013; 109(5): 825-33.
28. Alqahtani Z, Jamali F. Clinical Outcomes of Aspirin Interaction with Other Non-Steroidal Anti-Inflammatory Drugs: A Systematic Review. J Pharm Pharm Sci. 2018; 21(1s): 29854.
29. Capone ML, Tacconelli S, Sciulli MG et al. Clinical pharmacology of platelet, monocyte, and vascular cyclooxygenase inhibition by naproxen and low-dose aspirin in healthy subjects. Circulation. 2004; 109(12): 1468-71.
30. Kurth T, Glynn RJ, Walker AM et al. Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal antiinflammatory drugs. Circulation. 2003; 108(10): 1191-5.
31. Burmester G, Lanas A, Biasucci L et al. The appropriate use of non-steroidal anti-inflammatory drugs in rheumatic disease: opinions of a multidisciplinary European expert panel. Ann Rheum Dis. 2011; 70(5): 818-22.
32. Scarpignato C, Lanas A, Blandizzi C et al. Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis – an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC Med. 2015; 13: 55.
33. Samborski W, Filipiak KJ, Kaczmarczyk J et al. Niesteroidowe leki przeciwzapalne a powikłania sercowo-naczyniowe i gastroenterologiczne – algorytm wyboru. Choroby Serca i Naczyń. 2016; 13(4): 257-64.
34. Piepoli MF, Hoes AW, Agewall S et al. [2016 European Guidelines on cardiovascular disease prevention in clinical practice]. Kardiol Pol. 2016; 74(9): 821-936.
35. Trelle S, Reichenbach S, Wandel S et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011; 342: c7086. https://doi.org/10.1136/bmj.c7086.