Tuesday, January 04, 2005
Ibuprofen and naproxen not so bad after all?
[Alan Reynolds, "Painkiller panic," The Washington Times, 2 January 2005.]
It might be easy to understand people going through their houses and throwing out all of the Aleve and Advil after hearing news that relieving a head or back ache could result in a heart attack or stroke. As is often the case with over-the-top media reports, however, the reality is a bit more complex:
Depending on which of two recent studies you may have read about, you might suppose the pain reliever Alleve (naproxen) will either reduce or increase the risk of heart attacks.
On Dec. 13, the Financial Times reported, "Widely used anti-inflammatory drugs such as ibuprofen and naproxen could help reduce the risk of heart attacks, while abruptly halting the usage increases the risks, according to a large U.K. study."
On Dec. 21, The Washington Post dished out the opposite advice, noting, "Federal officials announced that naproxen, a painkiller sold by prescription and also over the counter as Aleve, might increase people's risk of having a heart attack."
What the press described as a "quick review of the data" in the United States may have suggested...I should stop using naproxen or risk a heart attack. But the larger British study said stopping naproxen would risk a heart attack. So, I decided to take a closer look at the U.S. version.
It turns out that in a study of about 2,400 older people, 70 of those using naproxen had some "cardiovascular event," such as a stroke or heart attack, but only two or three died. The 70 was said to be twice the rate among those taking a placebo. Press reports promptly ascribed that minor difference (1½ percent) to the added risk of taking a large daily dose of naproxen for three years.
For all we know, the difference might be because those taking naproxen ate fatter foods than most other participants, exercised less, were older, had worse family histories or smoked more cigarettes. Nobody said these other risk factors were properly taken into account, so the quick review lacks statistical credibility.
The hullabaloo about questionable risks from chronic overuse of such beneficent drugs as Celebrex and Alleve may yet cause truly serious health risks if it contributes to the terrifying FDA urge to deny doctors and patients timely access to vital drugs.
[Alan Reynolds, "Painkiller panic," The Washington Times, 2 January 2005.]
It might be easy to understand people going through their houses and throwing out all of the Aleve and Advil after hearing news that relieving a head or back ache could result in a heart attack or stroke. As is often the case with over-the-top media reports, however, the reality is a bit more complex:
Depending on which of two recent studies you may have read about, you might suppose the pain reliever Alleve (naproxen) will either reduce or increase the risk of heart attacks.
On Dec. 13, the Financial Times reported, "Widely used anti-inflammatory drugs such as ibuprofen and naproxen could help reduce the risk of heart attacks, while abruptly halting the usage increases the risks, according to a large U.K. study."
On Dec. 21, The Washington Post dished out the opposite advice, noting, "Federal officials announced that naproxen, a painkiller sold by prescription and also over the counter as Aleve, might increase people's risk of having a heart attack."
What the press described as a "quick review of the data" in the United States may have suggested...I should stop using naproxen or risk a heart attack. But the larger British study said stopping naproxen would risk a heart attack. So, I decided to take a closer look at the U.S. version.
It turns out that in a study of about 2,400 older people, 70 of those using naproxen had some "cardiovascular event," such as a stroke or heart attack, but only two or three died. The 70 was said to be twice the rate among those taking a placebo. Press reports promptly ascribed that minor difference (1½ percent) to the added risk of taking a large daily dose of naproxen for three years.
For all we know, the difference might be because those taking naproxen ate fatter foods than most other participants, exercised less, were older, had worse family histories or smoked more cigarettes. Nobody said these other risk factors were properly taken into account, so the quick review lacks statistical credibility.
The hullabaloo about questionable risks from chronic overuse of such beneficent drugs as Celebrex and Alleve may yet cause truly serious health risks if it contributes to the terrifying FDA urge to deny doctors and patients timely access to vital drugs.
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