NSAID is an abbreviation that stands for nonsteroidal anti-inflammatory drug. It’s a big drug class that includes a bunch of nonprescription drugs like Motrin, ibuprofen, Advil, Aleve, and Naprosyn and the prescription drugs Mobic, Celebrex, Voltaren, and others. They are the single most common medication taken for pain relief, with many traditional medical guidelines telling patients to take them. But do they do more harm than good? Could NSAIDS make arthritis worse?
The side effects of these drugs are nasty and include cardiac issues, like sudden-death heart attack, stroke, and stomach bleeding. The heart attack issue is a big one, prompting the American Heart Association to come out with a warning to patients and physicians to stop taking the drugs or to limit their use.
The new study was performed using data from the Osteoarthritis Initiative (OAI), a government-funded study that provides open source data on knee arthritis to researchers. There are thousands of people, both with and without arthritis, who are being tracked, each with detailed histories and serial X-ray and MRI imaging over time.
The researchers that tracked medication use sought to determine if there was either a good or bad long-term effect of taking these meds. As a result, they looked at MRI changes over many years in patients who were taking medications for pain (the vast majority of them were taking NSAIDs) or patients with arthritis who took nothing. Even after adjusting for all the things that could make these two groups of patients different (like arthritis severity), the patients taking meds had more arthritis progression over the eight years. How much more? About twice as much!
The first thing I did was to pull the full paper to see what these patients were taking. Sure enough, about two-thirds of them were taking NSAID drugs. Hence if there was a single medication culprit, it was most likely to be those drugs. NSAIDs block inflammation and can also hurt new bone formation, so one possibility is that the patients taking these drugs for years have less of a normal repair and maintenance response to wear and tear, leading to more joint breakdown.
The upshot? NSAIDs are bad news due to their heart attack effects. It’s regrettable that pharma has done a good job hiding these cardiac effects from most physicians and patients, because few really understand that Motrin could be the most dangerous over-the-counter drug money can buy. Now we have a new potential issue—the very arthritis that these drugs are supposed to help may be made worse by the drugs! You gotta love American medicine! We know, based on multiple high-level studies, that certain supplements will help arthritis pain and likely protect against worsening, but the pills doctors have been taught to push like giving a kid M&Ms is the drug that causes heart attacks, and truth being stranger than fiction, it also appears likely that NSAIDS make arthritis worse!
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…