Is there a link between non-steroidal anti-inflammatory drugs and cardiovascular risk in patients with inflammatory arthritis?

TL;DR

This paper explores whether NSAIDs increase cardiovascular risk in patients with inflammatory arthritis, suggesting they may actually be protective.

Contribution

The paper proposes that NSAIDs may have a cardioprotective effect in inflammatory arthritis patients due to their anti-inflammatory properties.

Findings

NSAIDs may not increase cardiovascular risk in inflammatory arthritis patients.

NSAIDs and coxibs appear to have a protective effect against cardiovascular events in these patients.

Anti-inflammatory properties of NSAIDs likely contribute to reduced cardiovascular risk.

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) require particular attention, as these pharmaceutical compounds have been associated with a range of adverse effects, such as renal and gastrointestinal toxicity. In addition, data suggest an increased cardiovascular (CV) risk in the general population, which indicates a need for caution regarding its application in patients with elevated CV risk. Patients with inflammatory arthritis demonstrate an inherent predisposition to an elevated risk of CV morbidity and mortality. In this publication, we examine the available data indicating that the utilization of NSAIDs among patients diagnosed with inflammatory joint disease is not associated with an elevated risk of developing CV disease. The analgesic and anti-inflammatory properties of NSAIDs are discussed as a potential underlying mechanism contributing to a cardioprotective effect. In this context, patients diagnosed with rheumatoid arthritis (RA) or ankylosing spondylitis (AS), who also exhibit systemic inflammation, have been observed to benefit in respect to CV events in response to utilization of NSAIDs.

•Patients with inflammatory arthritis (IA) exhibit a predisposition to an elevated risk of CV morbidity and mortality.•The utilization of NSAIDs or coxibs in patients diagnosed with IA requires a re-evaluation concerning CV risk.•Available data indicate that NSAIDs and coxibs promote a protective effect for CV events in IA patients.•The anti-inflammatory effect of NSAIDs is most probably the relevant factor in reducing CV events in IA and OA patients.

Patients with inflammatory arthritis (IA) exhibit a predisposition to an elevated risk of CV morbidity and mortality.

The utilization of NSAIDs or coxibs in patients diagnosed with IA requires a re-evaluation concerning CV risk.

Available data indicate that NSAIDs and coxibs promote a protective effect for CV events in IA patients.

The anti-inflammatory effect of NSAIDs is most probably the relevant factor in reducing CV events in IA and OA patients.

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