For now, naproxen seems to be the safest NSAID in terms of cardiovascular risk.
With any NSAID, consider also prescribing gastroprotective drugs.
NSAIDs are not the only option for treatment of musculoskeletal symptoms. Clinicians also prescribe paracetamol, low-dose opioid analgesics, and newer drugs, but without large-scale comparison studies, it's impossible to tell which is best for both efficacy and safety, Dr. Ray wrote. “Perhaps it is time for a larger, more systematic evaluation of a broader range of alternatives,” he suggested.
DR. WAYNE A. RAY is a professor and director of pharmacoepidemiology at Vanderbilt University, Nashville, Tenn. Dr. Ray has received financial support from Pfizer, was a paid expert witness in a lawsuit by the state of Texas against Merck, and is a paid expert in an insurance company action against the maker of Prempro.