Stroke risk and NSAIDs : a systematic review of observational studies

Copyright © 2011 John Wiley & Sons, Ltd..

AIMS: To perform a quantitative systematic review of observational studies on the risk of stroke associated with the use of individual NSAIDs.

METHODS AND RESULTS: Searches were conducted using the Medline database within PubMed (1990-2008). Observational cohort or case-control studies were eligible if reported on the risk of cardiovascular events associated with individual NSAIDs versus the nonuse of NSAIDs. We found 3193 articles, in which 75 were eligible for review and abstraction. Of the 75 articles, 6 reported relative risk (RR) of stroke. Data were abstracted into a database using a standardized entry form. Two authors assessed study quality, and discrepancies were resolved by consensus. The pooled RR of all subtypes of incident stroke was increased with the current use of rofecoxib (RR = 1.64, 95% CI = 1.15-2.33) and diclofenac (RR = 1.27, 95% CI = 1.08-1.48). The pooled estimates for naproxen, ibuprofen, and celecoxib were close to unity. The risk of ischemic stroke was also increased with rofecoxib (RR = 1.82, 95% CI = 1.09-3.04) and diclofenac (RR = 1.20, 95% CI = 0.99-1.45). Data were inadequate to estimate the pooled RR by dose and duration, for other individual NSAIDs or nonischemic stroke subtypes.

CONCLUSION: This meta-analysis supports an increased risk of ischemic stroke with the current use of rofecoxib and diclofenac. Additional studies are required to evaluate most individual NSAIDS, the effect of dose and duration, and the subtypes of stroke.

Medienart:

E-Artikel

Erscheinungsjahr:

2011

Erschienen:

2011

Enthalten in:

Zur Gesamtaufnahme - volume:20

Enthalten in:

Pharmacoepidemiology and drug safety - 20(2011), 12 vom: 11. Dez., Seite 1225-36

Sprache:

Englisch

Beteiligte Personen:

Varas-Lorenzo, Cristina [VerfasserIn]
Riera-Guardia, Nuria [VerfasserIn]
Calingaert, Brian [VerfasserIn]
Castellsague, Jordi [VerfasserIn]
Pariente, Antoine [VerfasserIn]
Scotti, Lorenza [VerfasserIn]
Sturkenboom, Miriam [VerfasserIn]
Perez-Gutthann, Susana [VerfasserIn]

Links:

Volltext

Themen:

Anti-Inflammatory Agents, Non-Steroidal
Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Anmerkungen:

Date Completed 22.03.2012

Date Revised 01.12.2018

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/pds.2227

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM211980560