Key result
Current use of NSAIDs in knee osteoarthritis patients was associated with an increased risk of venous thromboembolism compared to remote use (OR 1.43; 95% CI 1.36-1.49).
Why the study?
Does current use of specific NSAIDs increase the risk of venous thromboembolism in knee osteoarthritis patients compared to remote use?
Case-Control (n=24,079)
Yes
Does current use of specific NSAIDs increase the risk of venous thromboembolism in knee osteoarthritis patients compared to remote use?
Odds Ratio: 1.43 (95% CI 1.36–1.49)
Current use of most NSAIDs, except naproxen, is associated with an increased risk of venous thromboembolism in patients with knee osteoarthritis.
May warrant VTE caution with NSAIDs in knee osteoarthritis; leaves open causality and needs prospective confirmation.
OBJECTIVE: We aimed to examine whether the current users of specific NSAIDs have an increased risk of venous thromboembolism (VTE) among knee OA patients. METHODS: We conducted a population-based case-control study using The Health Improvement Network, a database of patient records from general practices in the UK. For every VTE case, we identified five controls matched on age, sex and calendar year of study enrolment. We used conditional logistic regression to assess the association between current use of specific NSAIDs and risk of VTE relative to remote NSAID users. RESULTS: Among knee OA patients with at least one NSAID prescription, we identified 4020 incident cases of VTE and 20 059 matched controls. Adjusted odd ratios (ORs) relative to the remote users were 1.38 (95% CI: 1.32, 1.44) for recent users and 1.43 (95% CI: 1.36, 1.49) for current users. Among the current NSAID users, the risk of VTE was increased with diclofenac [OR 1.63 (95% CI: 1.53, 1.74)], ibuprofen [OR = 1.49 (95% CI: 1.38, 1.62)], meloxicam [OR = 1.29 (95% CI: 1.11, 1.50)] and coxibs [celecoxib, OR = 1.30 (95% CI: 1.11, 1.51); rofecoxib, OR = 1.44 (95% CI: 1.18, 1.76)]; naproxen did not increase VTE risk [OR = 1.00 (95% CI: 0.89, 1.12)]. CONCLUSION: Compared with the remote users of NSAIDs, the risk of VTE increased for current users of diclofenac, ibuprofen, meloxicam, and coxibs, but not for naproxen, in the knee OA population. Clinicians should consider the risk profile for specific NSAIDs when recommending their use.
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Lee et al. (2016) conducted a case-control in Knee osteoarthritis (n=24,079). Current use of NSAIDs vs. Remote NSAID users was evaluated on Venous thromboembolism (VTE) (OR 1.43, 95% CI 1.36-1.49). Current use of NSAIDs in knee osteoarthritis patients was associated with an increased risk of venous thromboembolism compared to remote use (OR 1.43; 95% CI 1.36-1.49).
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