This research did not pan out. “The preponderance of data suggests that we should be very cautious about the use of these agents” in people with RA who also have heart failure, he says.


There have been many news reports about how pain-killing drugs known as COX-2 blockers increase heart attack and stroke risks. Additional studies suggested that older non- steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen could also elevate heart risks.

While these drugs are still under scrutiny, a new review of six studies of celicoxib (Celebrex) compared to a placebo in nearly 8,000 patients, which was published in the March 2008 issue of the journal Circulation, found that people with no established risk factors for heart disease, such as high cholesterol or high blood pressure, could safely take doses of up to 400 mg, twice a day, with no increase in the risk of cardiovascular events. Patients at moderate to high risk of heart disease, however, experienced more cardiovascular events when they took either 200 or 400 mg of Celebrex twice a day than if they took a single daily dose. Doctors think taking Celebrex just once a day may be the safest option for high-risk patients because it elevates blood pressure.

The jury is still out on every NSAID. “It seems,” Dr. Solomon says, that based on available research, “the NSAID that is safest for the heart is naproxen.”