We should not avoid diclofenac in the treatment of spondyloarthritis

Dubreuil et al. (1) report about the risk of myocardial infarction (MI) by NSAID in a nested-control study with patients suffering from spondyloarthritis (SpA). Current diclofenac use, but not naproxen use, was associated with an OR of 3.3 for MI when compared with remote use of any NSAID. Recent use of diclofenac had a lower risk (OR 1.40), whereas recent use of NSAID was not associated with increased MI outcome. In OA, the risk of diclofenac (OR 1.26) was not different with the risk of other NSAID (OR 1.17).