Non-Steroidal Anti-Inflammatory Drugs

Letters to the Editor The Safety of Antirheumatic Drugs by Dr. med. Johanna Mucke, Prof. Dr. med. Dr. h. c. Hans-Uwe Simon, and Prof. Dr. med. Gerd Rüdiger Burmester in issue 6/2022

The article (1) unfortunately understates the dangers of the drugs in one respect. Despite clear findings, it does not mention that there is a high risk of using non-steroidal anti-inflammatory drugs for patients with known or unknown cardiovascular diseases, which leads to an independent mortality in this patient group. This risk has nothing to do with the renal toxicity mentioned in the article (1). The aspects mentioned are important as chronic therapy with this group of drugs is standard for axial spondyloarthropathy, but these drugs should not be used in these patient groups (2, 3, 4).

DOI: 10.3238/arztebl.m2022.0183

Dr. med. Wolfgang Mitlehner

Practice for Internal Medicine, Pneumology, Allergology, and Pulmonary Oncology, Klappholz, Germany

Conflict of interest statement

The author declares that no conflict of interest exists.

References

1. Mucke J, Simon HU, Burmester GR: The safety of antirheumatic drugs. Dtsch Arztebl Int 2022; 119: 81–7

2. Sondergaard KB, Weeke P, Wissenberg M, et al.: Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: a nationwide case-time-control study. Eur Heart J Cardiovasc Pharmacother 2017; 3: 100–7

3. Gislason GH, Jacobsen S, Rasmussen JN, et al.: Risk of death or reinfarction associated with the use of selective cyclooxygenase-2 inhibitors and nonselective nonsteroidal antiinflammatory drugs after acute myocardial infarction. Circulation 2006; 113: 2906–13

4. McGettigan P, Henry D: Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med 2011; 8: e1001098