Pubdate: Sun, 05 Mar 2000
Source: Sunday Telegraph (UK)
Copyright: Telegraph Group Limited 2000
Contact:  http://www.telegraph.co.uk/
Author: Robert Matthews, science correspondent
Related: http://www.mapinc.org/drugnews/v00/n267/a10.html

PAINKILLERS CLAIM 2,000 LIVES A YEAR, SAY DOCTORS

PAIN-RELIEVING drugs, including Nurofen, Advil and Ibuleve, are killing
thousands of people each year, according to new research on the hidden cost
of long-term medication.

Each year many people take the so-called non-steroidal anti- inflammatory
drugs (NSAIDs) such as ibuprofen for joint, muscle and back pain and
symptoms of arthritis. After years of clinical trials, such drugs are
regarded as safe and many can be bought without prescription.

But medical researchers in Switzerland and Britain now say that these
trials were too small to reveal the subtle risks. After analysing more than
100 trials worldwide, which covered at least 200,000 patients, the team
found evidence that NSAIDs are killing about 2,000 people each year in
Britain alone, through gastric complications triggered by long-term use.

Reporting their findings in the latest issue of the journal Pain, the
researchers give a warning that long-term use poses "a substantial risk of
death", and advise doctors to ensure that patients are given the lowest
doses for the shortest possible time.

Dr Martin Tramer of University Hospital, Geneva, who led the research team,
said: "These are wonderful drugs, but they are toxic and there are
alternatives which do not carry the same risk of gastric complications.
These alternatives are more expensive, but this has to be weighed against
the fewer number of deaths they would cause."

Dr Tramer stressed that people taking NSAIDs sold over the counter, such as
Nurofen, Advil or Ibuleve, should not panic over the warnings. He said: "If
you just take these for a short time to relieve joint or back pain, there's
little to worry about. The risks are with patients who take these drugs
continuously for a couple of months or more, for conditions such as
arthritis."

However, the new findings raise concern over the many thousands of people
who take them for months without medical supervision. Prof Henry McQuay of
Churchill Hospital, Oxford, and a member of the research team, said: "The
public really need to know the risks involved." The findings have also been
greeted with concern by medical charities whose members take them
regularly.

"We have known about the side effects of these drugs for some time," said
Robina Lloyd of Arthritis Care. "I am appalled that they could be causing
2,000 deaths a year. We would like to see drugs companies making these
treatments safer."

Dr Frank McKenna, a consultant rheumatologist at Trafford General Hospital,
Manchester, and an adviser to the Arthritis Research Campaign, said: "Very
little attention has been paid to the effects of NSAIDs, despite the fact
that they kill more people each year than cervical cancer or asthma. It is
remarkable how much resistance there is to changing prescription habits."

Dr McKenna called for clear warnings about the dangers of their long-term
use. He said: "They should make clear that if no improvement is seen after
seven days, people should consult their GPs."

The Department of Health last night said that it was aware of the concern
posed by NSAIDs. A spokesman said: "Research into this area is always
welcome, and its results are fed into updating patient information given
with drugs."

Crookes Healthcare, the manufacturer of Nurofen - the leading brand of
ibuprofen - last night said that the product was excellent for short-term
pain relief, but was only recommended only for short-term use. Sharon
Buckle, the head of corporate affairs at the company, said: "If symptoms
persist for more than three days, you should consult your pharmacist or GP,
and we would caution people about treating themselves long-term."

She added that recent research had shown that ibuprofen is better tolerated
than aspirin in the short term, and at least as well tolerated as
paracetamol.

No one was available for comment at the manufacturers of Ibuleve or Advil
last night. The drugs carry warnings on all packages for users to consult
their doctor or pharmacist if symptoms persist for more than three days.