Spondyloarthritis (SpA) patients who took the nonsteroidal anti-Inflammatory drug (NSAID) diclofenac were at elevated risk for heart attack, although osteoarthritis (OA) patients who took that drug didn’t put themselves at greater heart attack risk. For SpA patients who took the NSAID naproxen, there didn’t appear to be a greater risk of heart attack. That’s according to research published in Annals of the Rheumatic Diseases.

Heart attacks “could be prevented through preferential use of naproxen,” wrote Maureen Dubreuil, of Boston University School of Medicine, and colleagues.

“While the association between cardiovascular risk and NSAID use has been scrutinized in the general population, risks among patients with spondyloarthritis have not been widely examined, despite their frequent use of NSAIDs as first-line treatment for pain and stiffness,” reports MedPage. “These drugs might either increase the risk, as in the general population, or decrease the risk by reducing systemic inflammation, the researchers noted.”

Dubreuil and colleagues studied 8,140 spondyloarthritis patients, 115 of whom had heart attacks, and 244,339 osteoarthritis patients, 6,287 of whom had heart attacks. Of the spondyloarthritis patients, 25 had taken diclofenac within the prior 6 months, and 14 were taking naproxen. Of the 6,287 diagnoses of heart attacks among the osteoarthritis patients, 843 were taking diclofenac and 339 were taking naproxen.

In an interview, Dubreuil told CreakyJoints that there isn’t enough evidence from this study alone to warrant different treatment, even if the findings may cause some concern.

“Similar studies should be conducted in other data sets and other populations to examine this issue,” she said. “If confirmed, it is possible that subsequent treatment guidelines would recommend for or against a specific NSAID as first line treatment in spondyloarthritis.’

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