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MI risk associated with naproxen and diclofenac in spondyloarthritis

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Review of: Dunbreuil M et al. Risk of myocardial infarction with use of selected non-steroidal anti-inflammatory drugs in patients with spondyloarthritis and osteoarthritis. Ann Rheum Dis 2018;77:1137–42.

Key learning points

  • NSAIDs are associated with an increased risk of thrombotic events.

  • Diclofenc has a less favourable cardiovascular risk profile compared with naproxen.

  • The risk of myocardial infarction associated with diclofenac was higher in people with spondyloarthritis than those with osteoarthritis.

An analysis of the incidence of myocardial infarction (MI) in people with spondylarthritis (SpA) and osteoarthritis (OA) treated with NSAIDs provides further evidence that diclofenac is associated with a higher risk than naproxen.

Overview

This nested case–control study used medical records from a database of 11 million patients registered with UK general practices to assess the risk of MI among patients with SpA (ankylosing spondylitis or psoriatic arthritis) who were prescribed NSAIDs. The authors aimed to test the hypothesis that MI …

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