Background NSAIDs are effective for control of the main symptoms of rheumatic diseases (RD) and they are widely used in clinical practice. However, NSAIDs can cause serious gastrointestinal (GI) and cardiovascular (CV) complications. Prevention of these complications based on an evaluation of risk factors.
Objectives To evaluate the presence of risk factors in patients requiring NSAID.
Methods We conducted a cross-sectional population study. In this study, 2021 physicians from 9 countries of former USSR within 2 weeks interviewed at least 10 patients who need treatment by NSAID. Inclusion criterions were the presence of severe musculoskeletal pain (>40 mm VAS) or the use of NSAIDs at the time of investigation. Data were obtained from 21 185 patients, 57.5% of women and 42.5% men, age 50.5±14.1 years, mostly with back pain (56.6%) and osteoarthritis (23.5%). The average intensity of pain (VAS) was 62.2±25.2 mm.
Results History of GI bleeding was found in 1.7%, history of peptic ulcer in 11.3%, 25.3% had dyspepsia, age over 65 years in 16.8%, the use of low-dose aspirin in 20.0%. The total number of patients at high risk of GI complications was 29.0%. The following proportion of patients met CV risk factors: myocardial infarction or stroke in 7.4%, IHD in 17.6%, hypertension in 36.5%, and diabetes in 7.8%. The total number of patients with high CV risk (without SCORE evaluation) was 23.0%. Many patients at high risk who have used NSAIDs did not receive effective prevention. Among patients with history of peptic ulcer only 70.3% used gastroprotective medications and among patients with history of CV events only 66.2% used low-dose aspirin.
Conclusions These data suggest that significant proportion of patients with RD who needs active analgesic therapy has serious risk of CV and GI complications. This limits the use of NSAIDs and determines the need for effective prevention or alternative methods of analgesia.
Disclosure of Interest None declared