Non-steroidal anti-inflammatory drugs-aspirin interactions and with risk of cardiovascular disease in patients osteoarthritis

Am J Epidemiol. 2023 Apr 19:kwad094. doi: 10.1093/aje/kwad094. Online ahead of print.ABSTRACTNon-steroidal anti-inflammatory drugs (NSAIDs) remain the mainstay of the pharmacologic management for relieving osteoarthritis (OA) pain and low-dose aspirin is often prescribed to OA patients who are at high risk of cardiovascular disease (CVD). We conducted cohort studies using data from The Health Improvement Network (THIN) database (2000-2019) to assess whether the relation of initiation of naproxen or ibuprofen vs. initiation of other NSAIDs (excluding both naproxen and ibuprofen), respectively, to the risk of CVD was modified by co-prescription of low-dose aspirin among the participants with OA. Among participants without co-prescription of aspirin, the risk of CVD was lower in naproxen initiators (10.3/1000 person-years) than in other NSAIDs initiators (13.2/1000 person-years) (hazard ratio (HR)=0.71, 95% confidence interval (CI): 0.60-0.85). Among participants with co-prescription of aspirin, however, the risk of CVD was higher in naproxen initiators (36.9/1000 person-years) than that in other NSAIDs initiators (34.8/1000 person-years) (HR=1.48, 95%CI:1.12-1.84). The association was significantly modified by co-prescription of aspirin (P<0.001). Similar findings were observed in the association of initiation of ibuprofen vs. other NSAIDs with the risk of CVD, which was significantly modified by co-prescription of aspirin (P<0.001). These findings suggest that OA patient...
Source: Am J Epidemiol - Category: Epidemiology Authors: Source Type: research