November 7, 2014 — Neurology has published a study adding growing evidence that painkillers in the COX-2 inhibitor class may increase a patients risk of death in the 30 days following a stroke.
The conclusions of the study were based on data from over 100,000 people in Denmark who were hospitalized after their first stroke between 2004-2012.
The researchers found a 19% increased risk of death within 30 days of a stroke for patients currently on a COX-2 inhibitor compared to non-users. There was a 42% increased risk of death after a stroke for new users of a COX-2 inhibitor, and 53% for patients on older COX-2 inhibitors like Lodine (etodolac).
Cardiovascular concerns about drugs in the COX-2 inhibitor class were raised in 2004, when Merck & Co. pulled Vioxx off the market. Three years later, the drug-maker paid nearly $5 billion to settle 27,000 lawsuits from people who blamed Vioxx on a heart attack, stroke, or wrongful death of a loved one.
The FDA asked Pfizer to stop selling another COX-2 inhibitor called Bextra (valdexocib) in 2005. However, Pfizer continues to market Celebrex (celecoxib), a painkiller in the COX-2 selective NSAID (non-steroidal anti-inflammatory drug) class, with a Black Box Warning about cardiovascular side effects.
Other NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve) were not associated with higher rates of death after a stroke.
Dr. Ralph Sacco of the University of Miami warned survivors of stroke to be cautious about their painkiller:
“This large study from Denmark adds to the prior concerns about COX-2 inhibitors and stroke risks. Patients at high risk for stroke should be cautious about taking such medications and should consult their physicians as to the best medications to treat inflammation and pain.”
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