REVIEW

Problem of the atherothrombotic potential of non-steroidal anti-inflammatory drugs

W W Bolten

Correspondence to:
Dr W W Bolten
Klaus Miehlke-Klinik, Rheumatology, Leibnizstr. 23, 65191 Wiesbaden, Germany; wbolten@em.uni-frankfurt.de

Treatment of pain in rheumatoid arthritis must take into account the gastrointestinal and cardiovascular risk of individual patients. Adequate results are not yet available, and until they are, treatment recommendations must take into account, not only the more favourable gastrointestinal risk profile of selective COX-2 inhibitors, but also the potential atherothrombotic risk of any NSAID or selective COX-2 inhibitor treatment.

Abbreviations: APC, Adenoma Prevention with Celecoxib; APPROVe, Adenomatous Polyp Prevention on Vioxx; ASA, acetylsalicylic acid; bid, twice a day; CABG, Coronary Artery Bypass Graft; CI, confidence interval; CLASS, Celecoxib Long term Arthritis Safety Study; COX-2, cyclo-oxygenase-2; CV, cardiovascular; GI, gastrointestinal; IV, intravenous; MI, myocardial infarction; NSAIDs, non-steroidal anti-inflammatory drugs; PGI₂, prostaglandin I₂; PPI, proton pump inhibitor; PreSAP, Prevention of Spontaneous Adenoma Polyps; RA, rheumatoid arthritis; tid, three times a day; TARGET, Therapeutic Arthritis Research and Gastrointestinal Event Trial; TXA₂, thromboxane A₂; VIGOR, Vioxx Gastrointestinal Outcomes Research

Keywords: non-steroidal anti-inflammatory drugs; atherothrombotic risk; COX-2 inhibitors

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This article has been cited by other articles:

• Voskuyl, A. E. (2006). The heart and cardiovascular manifestations in rheumatoid arthritis. Rheumatology (Oxford) 45: iv4-iv7 [Abstract] [Full Text]