Coxibs increased the risk of pulmonary embolism » Medvestnik


The risk of pulmonary embolism appears to be increased in people with inflammatory joint diseases. At the same time, traditional non-steroidal anti-inflammatory drugs reduce the likelihood of pulmonary embolism in such patients, and coxibs (selective cyclooxygenase-2 inhibitors) increase the risk of such a complication.

Researchers from Akershus University Hospital and Diakonhjemmet Hospital in Norway examined the association between the use of different groups of nonsteroidal anti-inflammatory drugs (NSAIDs) and pulmonary embolism in patients with inflammatory joint diseases. The study results were published in the European Heart Journal: Cardiovascular Pharmacotherapy.

The incidence of pulmonary embolism in the group of inflammatory joint diseases was 2.02 cases per 1000 patient-years. In the group without inflammatory joint diseases, the incidence of thromboembolism reached 1.01 cases per 1000 patient-years. The risk of pulmonary embolism in the group of inflammatory joint diseases increased by 1.6 times compared to the control group.

When analyzed, significant differences were found depending on the medications taken. Traditional NSAIDs reduced the risk of pulmonary embolism by 22% among patients with inflammatory joint disease and increased this risk by almost 1.7 times among patients without inflammatory joint disease. Coxibs increased the risk of pulmonary embolism in both groups: more than 1.7-fold among patients with inflammatory joint disease and almost three-fold in people without joint disease.




Data from 4.6 million adult patients were analyzed. Of these, more than 74 thousand participants suffered from inflammatory joint disease: more often rheumatoid arthritis, less often psoriatic arthritis and axial spondyloarthritis. The average follow-up time was nine years. The authors assessed the incidence of pulmonary embolism among patients with inflammatory joint diseases and people without this pathology, as well as those who took traditional NSAIDs and coxibs.



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