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Non-steroidal anti-inflammatory drugs (NSAIDs) have anti-inflammatory, antipyretic and analgesic effects and are widely used clinically for the treatment of osteoarthritis (OA), rheumatoid arthritis (RA) and many other inflammatory diseases.1 At present, NSAIDs are the first-line therapy for psoriatic arthritis and axial spondyloarthritis (SpA),2–4 but the use of NSAIDs may be related to the risk of myocardial infarction (MI).5 6 Recently, we read with great interest the paper entitled ‘Risk of myocardial infarction with use of selected non-steroidal anti-inflammatory drugs in patients with spondyloarthritis and osteoarthritis’ published online in 19 April 2018 in Annals of the Rheumatic Diseases. Dubreuil et al concluded that compared with remote use of any NSAIDs, the use of diclofenac in SpA was related to twofold to threefold risk of MI, but the use of naproxen did not increase the risk of MI in OA or SpA.7 Certainly, the findings of Dubreuil et al will be significant for clinicians, while there are still several questions that we would like to communicate with the …
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