Reducing deaths from prescribing of NSAIDs
I refer to the report 'GPs risk litigation for ignoring Government advice on NSAIDs' (June 2). There is no good evidence that a wider use of a Cox-2s would halve the death rate linked to adverse affects of standard NSAIDs.
The Food and Drug Administration data for Cox-2 inhibitors shows no benefit in terms of gastrointestinal mortality with Cox-2 inhibitors, a trend towards greater all-cause mortality and a significant increase in total serious adverse events (death, admission to hospital, any life-threatening event, or an event leading to serious disability). There was a 1.3 per cent absolute increase in the latter, corresponding to a number needed to harm for nine months of 78.
I assume the National Institute for Clinical Excellence will include these data when it reconsiders its advice on Cox-2s.
Finally we should remember that 2,500-3,000 patients die each year as a result of our NSAID prescriptions.
This is equivalent to the total annual
UK death rate from cervical cancer. We should be looking to reduce this figure not increase it.
Dr PG Weaving
North Cumbria Medicines Management Group chair
GP Brampton, Carlisle
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