NSAIDs linked to small intestine damage
cause gastrointestinal side effects than has been thought,
according to the results of a small study, reports Wai Lang
Chu.
The results aim another blow at the NSAID class, still reeling from the withdrawal from the market of Merck & Co's COX-2 inhibitor Vioxx (rofecoxib) after studies suggested that it raised the risk of cardiovascular events.
The study by researchers at Baylor College of Medicine in the US found that 71 per cent of patients who took painkillers such as ibuprofen to treat the symptoms of arthritis for more than three months suffered damage to their small intestines, while only 10 per cent of those on acetaminophen (also known as paracetamol) had these effects. The results were published in Monday's edition of the journal Clinical Gastroenterology and Hepatology.
This suggests that small intestine damage from NSAIDs is much more common than has been thought, according to the researchers.
"We have always known that NSAIDs can cause potentially deadly stomach complications, but the extent of the impact on the small intestine was largely unknown until now," said David Graham, the lead study author.
Everyday more than 30 million people take over-the-counter and prescription NSAIDs for pain relief, headaches and arthritis in the US alone, he said. Currently, there are about 20 NSAIDs available by prescription only. But many, including ibuprofen, naproxen, aspirin and ketoprofen are available over the counter.
Although NSAIDs and aspirin provide great benefit in terms of pain relief and cardioprotective effects, there is an increased risk of gastrointestinal complications ranging from stomach pain to ulcers.
Moreover, these drugs are responsible for severe and potentially deadly gastrointestinal problems. Each year, the side effects of long-term NSAID use cause nearly 103,000 hospitalisations and 16,500 deaths in the US.
Doctors have now been left with some difficult prescribing decisions for their arthritis patients, especially now that the safety concerns with Vioxx are now being extended to other COX-2 inhibitors.
A potential solution is the use of drug delivery technologies to limit GI toxicity, as discussed on DrugResearcher.com's sister site In-Pharmatechnologist.com, but what is clear is that there is a pressing need for new medications to provide alternatives to the NSAIDs.
One emerging target in osteoarthritis is reported in the lead article on DrugResearcher.com.
