Thursday, February 14, 2013

Popular Anti-Inflammatory Drug Poses Heart Risk

Medical Science

Aarticle in CBC News says a highly prescribed and popular inflammatory drug (Diclofenacposes the same risks for heart attacks as another drug (Vioxx) that its manufacturer (Merck & Co) voluntarily removed from the consumer market in 2004. Diclofenac falls under the category of a non-steroidal anti-inflammatory drug, or NSAIDs. The drug, made by a number of manufacturers, has been available in the UK since 1979.
Diclofenac is sold under a variety of brand names including Voltaren and is widely used for pain such as headaches, toothaches and arthritis. The pills are available with a prescription in Canada and over-the-counter elsewhere in the world. Writing in Tuesday's issue of the journal PLOS Medicine, published by the Public Library of Science, Dr. David Henry of the Institute for Clinical Evaluative Sciences in Toronto ranked the cardiovascular risks and sales of non-steroidal anti-inflammatories, or NSAIDs, in 15 countries including Canada, Australia, China, Pakistan and Vietnam.
"This is a drug that has about the same risk of causing heart attacks as a drug called Vioxx, which was withdrawn from the market eight years ago because of this adverse effect," Henry, who is also a clinical pharmacologist, said in an interview with CBC News. "We believe there’s no advantage over safer drugs, and we believe it should be withdrawn from world markets."
Despite having an equivalent cardiovascular risk to Vioxx or rofecoxib, diclofenac remains popular in many countries, with more than a third of the market for NSAIDs worldwide and about 15 per cent in Canada, Henry said. Henry advised against diclofenac in favour of safer NSAIDs such as naproxen for people with risk factors for heart disease such as high cholesterol or a history of heart disease. For those who have a low risk of heart attacks, diclofenac does not increase the heart risks to any great degree.
It's likely that with such a peer-reviewed scientific study, the many manufacturers—the drug is off-patent and made by a number of companies—will eventually remove the drug from the market. If so, this shows that Big Pharma is not immune to public safety, notably if scientific studies show that a drug has notable and proven deleterious effects on a subset of the population. As an interesting side note, the drug was widely used for veterinary use, but was banned across southern Asia in 2006 after it was determined that vulture populations who fed on dead cattle died from its ingestion.


You can read the original peer-reviewed article ("Use of Non-Steroidal Anti-Inflammatory Drugs That Elevate Cardiovascular Risk: An Examination of Sales and Essential Medicines Lists in Low-, Middle-, and High-Income Countries,") by Patricia McGettigan & David Henry, at [PLOS Medicine], and the rest of the news article at [CBC News]


  1. On the one hand, it is distressing that a medicine designed to do good does in fact do harm. On the other hand, reversals show that we can learn from experience and go on to improve treatment.

    1. Such are my thoughts. A part of me finds it disturbing that more recalls are taking place lately; it is either that drug-makers are rushing products to market or that there is more public oversight from the scientific medical community. I hope that it is the latter rather than the former.


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