More Evidence That Certain NSAIDs Up Post-Stroke Mortality
Celecoxib and other COX-2 inhibitors should be prescribed with care, experts say
THURSDAY, Nov. 6, 2014 (HealthDay News) -- Certain cyclooxygenase (COX)-2 inhibitors, including celecoxib (Celebrex) and etodolac (Lodine), are associated with increased mortality within a month after a stroke, according to a study published online Nov. 5 in Neurology.
Morten Schmidt, M.D., of the Aarhus University Hospital in Denmark, and colleagues analyzed data for 100,043 people hospitalized for a first stroke between 2004 and 2012. The authors sought to examine the association between nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) and 30-day stroke mortality.
The researchers found that use of celecoxib prior to hospitalization for ischemic stroke was associated with a 19 percent increase in risk of death within a month, compared with non-use of the drug. The older drugs -- for example, etodolac -- raised the risk of dying from stroke by 53 percent. Other types of NSAIDs -- including ibuprofen (Advil, Motrin) and naproxen (Aleve) -- weren't linked to an increased risk of death after stroke.
"Much of this result came from new users of the drugs, who were 42 percent more likely to die from stroke than those who were not taking the drugs. The results were also stronger for those taking the older COX-2 inhibitors," Schmidt told HealthDay. "There are several cardiovascular risks to consider when prescribing NSAIDs, in particular COX-2 inhibitors," he said. "Efforts should be made to ensure people with a higher risk of stroke are not prescribed these medications when other options are available."