Health

Cure the pain, kill the patient

A British study shows that the chronic use of pain killers commonly used for arthritis leads to the death of some two thousand patients each year. South African specialists confirm these findings.

Chronic use of commonly used pain killers for arthritis has this year led to the death of thousands of sufferers, according to a study published in London earlier this year.

The study found that oral non-steroidal anti-inflammatory drugs (NSAIDs) caused three times more deaths in Europe each year than diseases such as cervical cancer or malignant melanoma.

NSAIDs include drugs such as aspirin, ibuprofen (sold as Brufen, Inza, Nurofen), diclofenac (Voltaren), indomethacin (Indocid), naproxen (Naprosyn), ketoprofen (Oruvail), mefenamic acid (Ponstan).

Newer generations are piroxicam (Feldene) and meloxicam (Mobic).

The new study revealed that on average, one in 1 220 patients taking NSAIDs for at least two months would die from serious gastrointestinal bleeds and other complications caused by commonly used painkillers.

In the United Kingdom alone, 2 000 people are thought to die each year while millions are at risk.

“It is well known among physicians that these pain medications can cause stomach ulcers, which have the potential to progress, causing gastric bleeding and in some cases even death,” said Dr Thomas Tramer, of University Hospital and Geneva and the lead investigator in the study.

Yet despite this, NSAIDs continue to be widely used, particularly by people with arthritic disorders. In the UK, eight million people consult a physician each year with some form of arthritic disorder, of which half are aged 65 or over.

If only half of these took NSAIDs for more than two months, two million people were at risk and this in the UK alone.

Durban rheumatologist and head of the Durban Arthritis and Rheumatism Centre, Dr Savi Nayiager said between 60 and 80 percent of patients who died from bleeding or perforations of the stomach caused by NSAIDs had no warning symptoms.

“It happens very suddenly, often at home,” he said.

Nayiager said fortunately there were now new drugs available in South Africa to help patients manage chronic pain more safely.

Cape Town rheumatologist Dr Christopher Lyddell said: “There is more than enough published data to show that a significant number of people die as a consequence of gastrointestinal haemorrage and or perforations annually. At least 30% of this group has been exposed to chronic NSAID usage.”

Dr Tom Johnson, a general practitioner in the UK said the new findings had profound implications for the prescription of painkillers, particularly in those suffering with arthritic disorders and the elderly.

“Conventional NSAIDs are very effective painkillers, but this study confirms that they can also have serious consequences for patients,” Johnson said.

According to the latest statistics from the Arthritis Foundation, one in seven South Africans suffer from some form of arthritis.

The chronic disease affects males and females in South Africa three to one.

The UK study, published in the journal “Pain”, combined data from 15 randomised clinical trials, three cohort studies and 20 case series and case reports, giving data on a total of 250 000 patients.

The authors undertook the research because they believed that the trials, which had been carried out in this area in the past, were too small to give an accurate picture of the true risk associated with chronic use of NSAIDs.

About the author

Anso Thom