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Anti-Inflammatory Drugs Like Ibuprofen May Not Be Safe For Chronic Users

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Ibuprofen and naproxen have always been considered by doctors to be the better choice in pain relievers, but a study now suggests that it may not be so, after all.

Over-the-counter drugs that control inflammation, such as Advil, Aleve and Motrin, are among some of the most common prescription medicines people take. They are used to relieve short-term pain, and in higher doses, are prescribed to reduce inflammation caused by chronic conditions like arthritis.

However, recent studies have cast doubt over the safety of these drugs, so much so that the Food and Drug Administration put stricter warnings on the medicine labels on 2015. These addressed rising concerns about the risk of heart attacks and strokes the pain relievers are said to produce, TIME reports.

The most alarming thing about these nonsteroidal anti-inflammatory drugs (NSAIDs) is the increase in heart risks linked to a new class called the COX-2 inhibitors.

These drugs are supposed to be kinder on the stomach and intestines, preventing chemicals from destroying the protective lining of these organs that cause bleeding and pain.

But the safety of the stomach came at the price of the heart. Two of the COX-2 class painkillers were pulled from the market because research proved they were more likely to cause heart attacks and strokes.

Only one – celecoxib or Celebrex – is available for public consumption. Concerns over heart risks led the FDA to require Pfizer, the drug manufacturer, to pay for additional studies to ensure that celecoxib did not put people at these risks.

The study results surprised doctors and regulators: celecoxib not only turned out to pose no threat to the heart compared to ibuprofen or naproxen, but it also causes fewer kidney problems.

Dr. Steve Nissen, chair of cardiovascular medicine at the Cleveland Clinic and the study’s lead author, says, “I would never have guessed these results.” He further explains, “The whole world has been saying for a decade now that if you must take an NSAID, you probably ought take naproxen because it’s the safest. We just don’t see that in these results. In almost every measure, ibuprofen looks worse, naproxen is intermediate and celecoxib is the best.”

The researchers followed over 24,000 participants over five years for the study. All of them had heart problems, and were randomly assigned to take one of the three NSAID drugs for two years. Then the researchers tracked the participants for three more years to monitor heart attacks or strokes.

Those who took celecoxib did not show any higher incidences than the people who took ibuprofen or naproxen. Nissen and his team also found a lower risk for celecoxib in kidney risks.

NSAIDs are usually prescribed with ibuprofen or naproxen first, and celecoxib only if a patient had stomach issues. That might soon change in light of these results.

For people who take these pain relievers occasionally, and for short periods of time, they shouldn’t worry too much about their heart risks, the researchers say. The study did not include healthy people and short-term use is not likely to produce the same effect as continuous use of the medications.

The study was published in the New England Journal of Medicine.

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