Comparative Risk of Cardiovascular Outcomes Between Topical and Oral Nonselective NSAIDs in Taiwanese Patients With Rheumatoid Arthritis

Journal of the American Heart Association
Tzu-Chieh LinYea-Huei Kao Yang

Abstract

Topical NSAIDs have less systemic absorption than oral NSAIDs. We examined the risk of cardiovascular events associated with nonselective topical NSAIDs versus oral NSAIDs among patients with rheumatoid arthritis in Taiwan. We conducted a retrospective cohort study that included patients with incident rheumatoid arthritis who were newly starting therapy with nonselective topical NSAIDs or oral NSAIDs. We used the Taiwan National Health Insurance Research Database (NHIRD). The first date patients received either type of NSAID was defined as the index date. NSAID exposures continued until there was a treatment gap of >30 days. The main outcome was composite cardiovascular events, including myocardial infarction, unstable angina, heart failure, stroke, or revascularization. Follow-up was censored at treatment discontinuation, switch or addition of other NSAID category, cardiovascular outcome, death, or the end of the study. Propensity score weighted Cox regression models were used to compare the risk of cardiovascular events between topical NSAIDs and oral NSAIDs. There were 10 758 and 78 056 treatment episodes for topical and oral NSAIDs identified. After weighting by propensity score, the cohorts were well balanced over all cova...Continue Reading

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Citations

Oct 4, 2018·European Journal of Clinical Pharmacology·Tahmina Nasrin PolyYu-Chuan Jack Li
Sep 29, 2018·Cardiovascular Diabetology·Chia-Ter ChaoUNKNOWN COhort of GEriatric Nephrology in NTUH (COGENT) study group
Feb 4, 2021·Current Pain and Headache Reports·Jillian MaloneyNatalie Strand
Sep 21, 2020·Journal of the American Academy of Dermatology·Kevin T SavageLauren A V Orenstein

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