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Pain Relievers May Be More Of A Concern Than Previously Suspected BOSTON, MA -- June 17, 1999 -- In a review article published in this week's issue of The New England Journal of Medicine, Boston University School of Medicine (BUSM) researchers discussed significant and potentially fatal side-effects of nonsteroidal anti-inflammatory drug (NSAID) use. NSAIDs include medications such as aspirin, ibuprofen (Advil, Motrin), naproxen sodium (Aleve, Naprosyn, Naprox), diclofenac (Voltaren), indomethacin (Indocin), and many others. M. Michael Wolfe, MD, professor of medicine at BUSM and chief of the section of gastroenterology in the department of medicine at Boston Medical Center led the study. "This is, in many ways, a silent epidemic because gastrointestinal complications are not preceded by any warning signs in a majority of individuals," Wolfe said. Many primary care physicians and consumers may not necessarily be aware of the potential for NSAIDs to cause serious and sometimes fatal side-effects. "Only a minority of patients who have serious gastric complications reported any kind of discomfort or dyspepsia,” he said. "We've got to increase the awareness level of what is a very serious problem." Wolfe and his colleagues reviewed mortality reports from a number of sources, including data related to arthritis sufferers on long-term NSAID therapy. They concluded that in a small but substantial number of people, serious adverse gastrointestinal complications do occur. "In many cases, potentially fatal events occur as a direct result of gastrointestinal damage due to NSAID use," Wolfe explained. "Even someone who may take aspirin for something as simple as muscle pain is at high risk for gastric damage. Although the individual risk is quite low, owing to the enormous number of individuals taking these drugs, we estimate that approximately 16,500 deaths occur annually in the U.S. from ulcer-related complications associated with their use." With approximately 26 billion NSAID and aspirin tablets consumed annually without prescription and greater than 100 million NSAID prescriptions, Wolfe added that there is a significant portion of the population at high risk for gastrointestinal bleeding and other complications. Wolfe and his colleagues also stressed the importance of identifying those individuals at highest risk and discuss measures that can be taken to decrease the possibility of an ulcer complication. Related Link: The New England Journal of Medicine E-mail this page to a friend or colleague! To print, use this version