Wednesday, 13 February 2013

Diclofenac causes 14,000 deaths a year in China and should be banned: researchers

The anti-inflammatory drug diclofenac should be withdrawn from sale in China because of its high risk of cardiovascular adverse effects that may be responsible for 14,000 deaths a year, researchers say.
The call to withdraw the drug comes from UK and Indian researchers who found that diclofenac was still the most popular NSAID drug for pain and arthritis in countries such as China despite having a higher risk of cardiovascular disease.
They called for the drug to be removed the the list of essential medicines because safer alternatives such as ibuprofen and naproxen are available. For China, they estimate that
"The findings  ... have significant implications for public health. In China the age- and sex-standardised death rate from cardiovascular disease is estimated to be 312/100,000 for males and 260/100,000 for females. Diclofenac is the most commonly used NSAID in hospitals in China.  If it were taken by only 1% of China's population of approximately 1.3 billion annually, based on the relative risk calculations from meta-analyses it could cause 14,000 additional unintended deaths. These deaths are preventable - lower risk NSAIDs, including naproxen and low-dose ibuprofen, are widely available and are equally efficacious," they write.
According to the researchers, NSAID recommendations on national essential medicines lists should be based on the optimum balance of benefit and harm and give preference to low risk drugs, in particular to ibuprofen and naproxen.
"Diclofenac has no advantage in terms of gastrointestinal safety and it has a clear cardiovascular disadvantage. Given the availability of safer alternatives, diclofenac should be de-listed from national EMLs. There are strong arguments to revoke its marketing authorisations globally."
Source: PLOS Medicine

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