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Naproxen carries higher gastro-intestinal risk than other NSAIDs

By Lilian Anekwe

Patients taking naproxen are at significantly higher risk of gastro-intestinal damage than those on other anti-inflammatory drugs, new research suggests.

A US study found patients taking naproxen suffered more gastro-intestinal damage, and took longer to recover, than those on other NSAIDs or an antiplatelet.

The research comes against a backdrop of rising prescribing of naproxen, according to the latest National Prescribing Centre figures.

Prescribing of diclofenac has declined by 5% since November 2007, when the Medicines and Healthcare Products Regulatory Agency advised GPs to prescribe naproxen or ibuprofen as first-line NSAID. As a result, naproxen use rose by 4% over the same period.

The drug also became available for sale over the counter in April 2008 for the treatment of primary dysmenorrhoea.

But a study of 108 patients with no history of gastro-intestinal conditions assessed mean injury scores seven days after treatment by endoscopy, and found naproxen caused more damage than other drugs.

Scores averaged 4.33 with 1,000mg naproxen, compared with 3.03 with placebo, 2.68 for 300mg clopidogrel, 3.22 for 300mg aspirin and 3.15 for 800mg celecoxib.

Some 72% of patients on naproxen had at least one unhealed lesion, compared with 36% of those on placebo and 32% with clopidrogel.

Study leader Dr James Aisenberg, a gastroenterologist at the University of Medicine and Dentistry of New Jersey, concluded: ‘At standard doses, oral naproxen significantly impairs gastric and duodenal mucosal healing and this impairment is greater than that caused by aspirin or celecoxib.'

The study is published online in the journal Alimentary Pharmacology & Therapeutics.

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