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. Copyright (c) 2011 John Wiley & Sons, Ltd
Stroke risk and NSAIDs
A systematic review of observational studies
Varas-Lorenzo, C., Riera-Guardia, N., Calingaert, B., Castellsague, J., Pariente, A., Scotti, L., Sturkenboom, M., & Perez-Gutthann, S. (2011). Stroke risk and NSAIDs: A systematic review of observational studies. Pharmacoepidemiology and Drug Safety, 20(12), 1225-1236. https://doi.org/10.1002/pds.2227
Abstract
Publications Info
To contact an RTI author, request a report, or for additional information about publications by our experts, send us your request.
Meet the Experts
View All ExpertsRecent Publications
Article
Protection of forest ecosystems in the eastern United States from elevated atmospheric deposition of sulfur and nitrogen
Article
The use of patient experience feedback in rehabilitation quality improvement and codesign activities
Article
SPTSSA variants alter sphingolipid synthesis and cause a complex hereditary spastic paraplegia
OCCASIONAL PAPER