Ibuprofen and naproxen reduce cardiovascular risk in gout patients, reveals study

A recent research found that the use of non-steroidal anti-inflammatory drugs (NSAIDs) might reduce the risk of cardiovascular events in the patients with gout. The key findings were published in the recent edition of Rheumatology International journal.

Gout is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot and swollen joint. It is typically treated with medications that lower uric acid levels and anti-inflammatory drugs. While NSAIDs such as ibuprofen, naproxen and diclofenac are effective at managing pain and inflammation associated with gout, these have been linked to potential cardiovascular risks due to their prothrombotic, hypertensive and proarrhythmic side effects.

This research was conducted over a span of 23 years from 1997 to 2020 and analyzed data from a total of 59,150 Danish residents who experienced their first gout attack and later suffered a cardiovascular event. This study utilized a case-crossover design and employed the Mantel–Haenszel method to assess the odds ratios and 95% confidence intervals for cardiovascular outcomes related with NSAID use. The results indicated a 12% overall decrease in the odds of experiencing cardiovascular events among the individuals using NSAIDs. Also, the use of ibuprofen and naproxen was linked with reduced odds of a cardiovascular event with odds ratios of 0.92 and 0.85, respectively. Importantly, diclofenac did not show a statistically significant effect with an odds ratio of 0.97.

The research further detailed that the lowered risk was consistent across various types of cardiovascular incidents such as myocardial infarction, ischemic stroke, congestive heart failure, atrial fibrillation/flutter, and cardiovascular death included in the study. This suggests a potentially protective effect of NSAIDs when used in the context of gout treatment.

These findings challenge the existing concerns over the cardiovascular safety of NSAIDs in gout patients and suggest that certain NSAIDs, specially ibuprofen and naproxen, might offer cardiovascular benefits or at least a safer profile when compared to diclofenac. This is particularly relevant given the high prevalence of gout and cardiovascular diseases globally.

The outcomes of this study potentially influence the clinical decisions and public health guidelines regarding the management of gout and the prescription of NSAIDs. Further research is imperative to confirm these findings and explore the mechanisms behind the differential impacts of various NSAIDs on cardiovascular health.

Source:

Bech-Drewes, A., Bonnesen, K., Hauge, E.-M., & Schmidt, M. (2024). Cardiovascular safety of using non-steroidal anti-inflammatory drugs for gout: a Danish nationwide case-crossover study. In Rheumatology International. Springer Science and Business Media LLC. https://doi.org/10.1007/s00296-024-05584-7