In recent years, many have warned about the dangers of using NSAIDs to try to counter the pain from arthritis. Generally, users hope to reduce pain and inflammation which is of course, a problem for OA sufferers. Recent technology has provided the means to investigate these dangers more completely. Unfortunately, the news only gets worse for users of NSAIDs. The new technology has not only confirmed the high risk of danger but found an additional danger.
New Technology finds major problems previously not viewable
According to two sources, over 100 million prescriptions (not to mention over-the-counter sales) are written for NSAID’s annually in the US alone. (Acetaminophen; Indomethacin; Naproxen; Oxyprozocin, etc.) And, if a (patient) were to experience gastrointestinal problems, the standard method of assessing the digestive tract was through the use of endoscopes. (Pretty nice pictures since this author had some done in December of 2002.) However, science has now brought us an incredible new diagnostic tool.
Now, with the development of a new “swallowable, capsule-size camera” the ability to analyze the extent of damage caused by using NSAID’s, previously unknown, presents an entirely new picture of what can happen even to casual users.
The Risk Factor
Until now, what we knew (clinically) about NSAID’s was that they had the potential for causing stomach ulcers; cramping; nausea; indigestion; diarrhea; constipation; headaches; tension, etc.
A Recent Study Using A "Micro-camera”
Researchers from the Baylor College of Medicine conducted a study using the recent technology advances and reported the study results in 2003. Their findings can be read at: http://www.bcmfindings.net/vol1/is6/03june_n1.htm The researchers presented the study at the May 2003 Digestive Disease Week conference in Orlando, Florida.
The study showed that 71 percent of NSAID users had an injury in the small intestine compared to 5 percent of non-NSAID users. Dr. David Graham, M.D., who was the lead author of the study and is a professor of medicine and molecular virology at Baylor College of Medicine in Houston and chief of the gastroenterology section at the Houston VA Medical Center, stated that, "According to the images, patients who take NSAIDs regularly have an increased risk of small intestinal mucosal ulceration and bleeding."
A study of forty (40) patients with a mean age of approximately fifty (50) years (all of whom had either osteoarthritis, gout or rheumatoid arthritis) was conducted for a period of three (3) months. Each took NSAID’s daily. The clinical assessments that followed this controlled study was a new piece of equipment called a “capsule endoscope”, a device developed by Given Imaging. So, what does this new diagnostic tool do?
This new “disposable” camera is swallowed by the patient. It takes a “video” of the entire digestive tract and produces color images with no consequences to the patient. (The device is used to diagnosis “Crohn’s Disease, Celiac disease, benign/malignant tumors and of small intestine; vascular disorders; medication-related small bowel injury and pediatric small bowel disorders.”)
Twenty of the forty patients took acetaminophen only or nothing at all. The sphincter muscle that controls the lower opening of the stomach (at the point where it empties into the upper portion of the small intestine) was marked on the video. The results were shocking to say the least. Twenty-three percent (23%) of those using acetaminophen as opposed to those who took nothing were reported to have severe damage to the small bowel.
These researchers concluded that periodic diagnostic monitoring using this new technology was recommended for those who use NSAID’s on a regular basis.
The FDA Identifies Safety Problems With NSAID Use
The FDA has been more closely examing NSAIDs in recent years and publishing repeated warnings about some serious problems associated with their use. In September 2002, the Nonprescription Drugs Advisory Committee, along with experts from other committees, examined the evidence of U.S. cases of accidental and unintentional overdoses with NSAIDs and acetaminophen and related cases of gastrointestinal (GI) and renal (kidney) toxicity and identifed certain risk factors. The advisory committee's discussions and advice are at: http://www.fda.gov/ohrms/dockets/ac/cder02.htm#NonprescriptionDrugs
In January 2004, the FDA's Center for Drug Evaluation and Research (CDER) reiterated the concerns raised by the 2002 investigation when the CDER sent a letter to every State Board of Pharmacy to advise of safety issues for products containing NSAIDs or acetaminophen -- more specifically, the risk factors for GI bleeding and renal toxicity from their use.
Has enough been said about the dangers associated with NSAID’s? If you have not read the information on our websites and in “The Arthritis Chronicle,” please do so.
Stay with what we all know is clinically safe. If you suffer from osteoarthritis, high-quality glucosamine formulas can help control your pain and rehabilitate damaged cartilage without causing you to face all of the safety problems associated with NSAIDs.
J.R. Rogers is the founder and President of Activex America, Inc. makers of Liquid Glucosamine Formula Syn-flex®
Last updated: 1/31/05