Non-steroidal anti-inflammatory drugs: assessment of risks.

The prescription-event monitoring procedure developed at the University of Southampton was used to evaluate five different non-steroidal anti-inflammatory drugs (NSAIDs), including piroxicam, in approximately 55,000 patients. The overall incidence of side effects was what would be expected. The risks of gastrointestinal haemorrhage and peptic ulceration were spread uniformly across the five drugs under study. No real difference was seen in the incidence of these conditions when patients discontinued the medication or switched to another NSAID. Overall, serious side effects were extremely rare. One provocative finding was the possibility that drugs of this class may exert a cardioprotective effect. There appeared to be a deficit of cases of myocardial infarction while the patients were taking an NSAID. Responsibility for the efficacy and safety of all drugs resides with many people and organizations: the manufacturers, national health departments, licensing departments, and physicians. The press, which has contributed to many unwarranted panics concerning drug safety, also must refrain from using power without responsibility.