Doctors treating people for chronic pain should avoid using all medications — at least at first — the American Heart Association advised yesterday in guidelines designed to have a significant impact on the use of medications known as nonsteroidal anti-inflammatory drugs, or NSAIDs. The scientific statement said that, with the exception of aspirin, there is now strong evidence that NSAIDs are associated with an increased risk of heart attacks and stroke. If 100 patients who have had heart attacks in the past or are at risk for heart disease take these drugs for a year, researchers would expect to see six additional deaths in this group. NSAIDs reduce fever, pain and inflammation. The statement expressed particular concern over a subgroup of these drugs known as Cox-2 inhibitors. The only drug in this group currently on the market in the United States is Celebrex. The professional association laid out a step-by-step approach that is very different from the way physicians typically have approached treating chronic pain and inflammation. ‘In the past, many physicians would prescribe the Cox-2 drugs first,’ said Elliott Antman, a professor at Harvard Medical School who led a group of experts assembled by the […]