title: Use of non-steroidal anti-inflammatory drugs correlates with the risk of venous thromboembolism in knee osteoarthritis patients: a UK population-based case-control study.
abstract: We aimed to examine whether the current users of specific NSAIDs have an increased risk of venous thromboembolism (VTE) among knee OA patients.
  
  
  
  We conducted a population-based case-control study using The Health Improvement Network, a database of patient records from general practices in the UK. For every VTE case, we identified five controls matched on age, sex and calendar year of study enrolment. We used conditional logistic regression to assess the association between current use of specific NSAIDs and risk of VTE relative to remote NSAID users.
  
  
  
  Among knee OA patients with at least one NSAID prescription, we identified 4020 incident cases of VTE and 20 059 matched controls. Adjusted odd ratios (ORs) relative to the remote users were 1.38 (95% CI: 1.32, 1.44) for recent users and 1.43 (95% CI: 1.36, 1.49) for current users. Among the current NSAID users, the risk of VTE was increased with diclofenac [OR 1.63 (95% CI: 1.53, 1.74)], ibuprofen [OR = 1.49 (95% CI: 1.38, 1.62)], meloxicam [OR = 1.29 (95% CI: 1.11, 1.50)] and coxibs [celecoxib, OR = 1.30 (95% CI: 1.11, 1.51); rofecoxib, OR = 1.44 (95% CI: 1.18, 1.76)]; naproxen did not increase VTE risk [OR = 1.00 (95% CI: 0.89, 1.12)].
  
  
  
  Compared with the remote users of NSAIDs, the risk of VTE increased for current users of diclofenac, ibuprofen, meloxicam, and coxibs, but not for naproxen, in the knee OA population. Clinicians should consider the risk profile for specific NSAIDs when recommending their use.
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston.
authors.forename: Taeyeon
authors.initials: T
authors.lastname: Lee
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital.
authors.forename: Na
authors.initials: N
authors.lastname: Lu
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston Section of Rheumatology, Boston University School of Medicine, Boston.
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
authors.affiliation: Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital.
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
authors.affiliation: Section of Rheumatology, Boston University School of Medicine, Boston.
authors.forename: Deepan S
authors.initials: DS
authors.lastname: Dalal
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Section of Rheumatology, Boston University School of Medicine, Boston VA Boston Healthcare System, USA Rheumatology Division, Boston, MA, USA mdubreui@bu.edu.
authors.forename: Maureen
authors.initials: M
authors.lastname: Dubreuil
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016022:Case-Control Studies; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects; D004008:Diclofenac / Q000009:adverse effects; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects; D007783:Lactones / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D000077239:Meloxicam; D008875:Middle Aged; D009288:Naproxen / Q000009:adverse effects; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D012307:Risk Factors; D013450:Sulfones / Q000009:adverse effects; D013843:Thiazines / Q000009:adverse effects; D013844:Thiazoles / Q000009:adverse effects; D016896:Treatment Outcome; D006113:United Kingdom; D054556:Venous Thromboembolism / Q000139:chemically induced*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D007783:Lactones; D013450:Sulfones; D013843:Thiazines; D013844:Thiazoles; C116926:rofecoxib; D004008:Diclofenac; D009288:Naproxen; D000077239:Meloxicam; D007052:Ibuprofen
keywords: NSAIDs; VTE; knee osteoarthritis