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NSAIDs and cardiovascular risk

Posted by Tukaram on 13 Feb 2013 at 16:24 GMT

Authors didn't provide absolute risk and number needed to harm. Can these be made available to better interpret practical implications of the findings?

No competing interests declared.

RE: NSAIDs and cardiovascular risk

mddah02 replied to Tukaram on 19 Feb 2013 at 22:04 GMT

This paper was written to draw attention to the possible public health impacts of the widespread use of high risk NSAIDs (diclofenac and etoricoxib) in LMIC facing a rising epidemic of cardiovascular disease. The relative risk values reported in the paper (and in many other publications) can be applied to a range of background risks to derive estimates of the excess risk associated with use of the drug. If a patient has a background risk of (say) 1/100 then this will be increased to around 1.4/100 by either diclofenac or rofecoxib (Vioxx). That difference of 0.4% means that of every 250 treated patients one would suffer an additional heart attack with diclofenac or rofecoxib. However, if the background risk is 1/10 the excess risk is 4% meaning that of every 25 patients in that high risk group who receive treatment one will suffer an additional heart attack. These risks are easily calculated and may be helpful for individual decision making but they are not the focus of this paper.

No competing interests declared.