Another day, another report of the potential dangers of nonsteroidal
anti-inflammatory drugs (NSAIDs). Millions of people take
NSAIDs each year for a number of conditions, specifically
to relieve pain and
reduce inflammation. However,
these analgesic and anti-inflammatory benefits can be accompanied
by dangerous side effects, particularly gastrointestinal complications.
How dangerous are NSAIDs? A British study in the journal
Pain reviewed 49 randomized, controlled trials with
data on gastric or duodenal ulcer, ulcer hemorrhage or perforation,
and death attributable to NSAID (aspirin) use. The authors
estimated that one in 1,200 patients taking NSAIDs for at
least two months died from gastroduodenal complications. They
also estimated that 2,000 people in the United Kingdom die
each year from gastroduodenal lesions who would not have died
if they were not taking NSAIDs.
The authors are quick to note that different NSAIDs are no
doubt associated with different degrees or types of risk,
and that these risks may be influenced by patient-related
factors such as age or disease. However, they also note that
their results "strongly" suggest that chronic oral NSAIDs
pose a high risk of adverse effects and urge that "patients
receive minimum effective doses for the minimum possible time."
Always ask your doctor about the potential risks of any medications
you may be taking, and inquire about possible nonpharmaceutical
alternatives to managing your condition.
Tramer MR, Moore RA, Reynolds DJM, et al. Quantitative estimation
of rare adverse events which follow a biological progression:
a new model applied to chronic NSAID use. Pain 2000:
Vol. 85, pp169-82.