February 24, 2015
Alliance Response to 2/24/15 JAMA Article and Editorial
EUGENE, OR — The Alliance for the Rational Use of NSAIDs commends the work by Olsen and colleagues published in JAMA on Feb. 24, 2015 (JAMA. 2015;313(8):805-814). Their Danish study demonstrated an association between the use of NSAIDs and the risk of bleeding or subsequent cardiovascular events after a patient suffers an acute myocardial infarction (also called an MI or heart attack). The authors conclude that physicians should exercise caution when prescribing non-aspirin NSAIDs for patients who recently experienced a heart attack.
“The Alliance respectfully suggests that patients who recently experienced a heart attack must also exercise caution regarding the use of NSAIDs,” said Byron Cryer, MD and chairperson of the Alliance. “In order for this to occur, people who use NSAIDs must be educated to be ‘NSAID aware’, so that they know what they are taking. This education must occur at the bedside, at discharge, in the office and in the pharmacy. Only then will patients and clinicians be partners in health and ensure appropriate use of NSAIDs.”
The results of the study highlight the need to use NSAIDs with knowledge and forethought. The accompanying editorial published in the same issue of JAMA correctly notes that, unlike in Denmark, NSAIDs are both commonly used OTC products and commonly prescribed medications in the US, and many people only recognize NSAIDs by product or brand name and not as a member of the NSAID class of medications. This potentially leaves them unaware of instruction to limit NSAID dose and duration of use or avoid them all together.
“While the mission of the Alliance is to raise professional and consumer awareness of the need to use any NSAID at the lowest effective dose for the shortest duration of time required for symptomatic relief, Olsen’s work demonstrates that NSAIDs are not appropriate for everyone,” said Cryer, who is also an associate dean at the University of Texas Southwestern Medical Center. “The study and accompanying editorial correctly caution against the use of NSAIDs by those at greatest risk, like people who recently suffered a heart attack. The concept of NSAID avoidance for those at greatest risk is in accordance with previous recommendations, like those of the American Heart Association.”
The Alliance for Rational Use of NSAIDs—a public health coalition—aims to bridge the gap between guidance and clinical practice, educating health care professionals and the public at-large to ensure appropriate and safe use of NSAIDs.
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