For over 2 millennia, physicians have strived to relieve pain, heal, and cause no harm. However, we depend on therapeutic drugs that have side effects and unknown pleiotropic effects. A host of publications and media coverage over the last 2 years alerted us to cardiovascular (CV) risks associated with chronic use of nonselective, nonsteroidal antiinflammatory drugs (NSAIDs) and selective cyclo...

By the time this editorial is printed, there will already have been hundreds of thousands of words written about the withdrawal of rofecoxib from the commercial market and the placement by Food and Drug Administration on ‘‘clinical hold’’ of all celecoxib colorectal adenoma prevention studies (1). The extremely promising role for rofecoxib and celecoxib, as well as other selective cyclooxygenas...

BACKGROUND Multivariable confounder adjustment in comparative studies of newly marketed drugs can be limited by small numbers of exposed patients and even fewer outcomes. Disease risk scores (DRSs) developed in historical comparator drug users before the new drug entered the market may improve adjustment. However, in a high dimensional data setting, empirical selection of hundreds of potential ...

Non-steroidal anti-inflammatory drugs (NSAIDs) are at the cornerstone of treatment for osteoarthritis (OA). In recent years, the widespread use of oral NSAIDs has been called into question due to the appearance of significant upper gastrointestinal (GI) complications and cardiovascular (CV) adverse events (AEs). However, NSAIDs are non-homogeneous, and there are noticeable differences between t...

BACKGROUND Mycobacterium tuberculosis (TB) is one of the world's most devastating public health threats. Our goal is to evaluate whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) affect the risk of new incident active TB disease. METHODS We conducted a nested case-control analysis by using a 1 million longitudinally followed cohort, from Taiwan's national health insurance rese...

The objective was to measure the impact of exposure to coxibs and non-steroidal antiinflammatory drugs (NSAID) on morbidity and mortality in older patients with acute myocardial infarction (AMI). A nested case-control study was carried out using an exhaustive population-based cohort of patients aged 66 years and older living in Quebec (Canada) who survived a hospitalization for AMI (ICD-9 410) ...

AIMS Non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors (COXIBs) may be associated with increased cardiovascular (CV) risk and mortality in CV patients. After the release of Note 66 by Agenzia Italiana del Farmaco (AIFA) to reduce inappropriate prescribing of NSAIDs and COXIBs, the CARDIOPAIN initiative was started in Italy to include such recommendations into the hospital disc...

BACKGROUND In Europe, scant information is available about prescription practices for pain medications. The aim of this research was to assess changes in prescription rates of non-opioid, weak opioid, and strong opioid medications between 2006 and 2013 in the Swiss population. METHODS Using insurance claims data covering one-sixth of the Swiss population, we analyzed the numbers of reimbursed...