Abstract: SA-PO0246
Kidney Safety of Nonsteroidal Anti-Inflammatory Drugs in Patients with Arthritis: A Network Meta-Analysis
Session Information
- Pharmacology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
- 2000 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
Authors
- Ahmed, Zahoor, Jefferson Einstein Philadelphia Hospital, Philadelphia, Pennsylvania, United States
- Kanwal, Sidra, Avicenna Medical College, Lahore, Punjab, Pakistan
- Noori, Noorahman, Jinnah Hospital, Lahore, Punjab, Pakistan
- Masood, Maliha, Jinnah Hospital, Lahore, Punjab, Pakistan
- Samreen, Iqra, Parkview Health, Fort Wayne, Indiana, United States
Background
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for arthritis (rheumatoid arthritis, osteoarthritis, other arthropathies). Although renal toxicity of some NSAIDs has been established, their safety varies widely. This study provides an extensive analysis of NSAIDs-related renal adverse events (AEs) in arthritis patients.
Methods
We conducted a systematic search using PubMed, Embase, and ClinicalTrial.gov for FDA-approved NSAIDs from inception to 2025. We performed a network meta-analysis (NMA) with a Bayesian framework in R Studio v.4.4.3. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for each effect size, and league tables were computed to compare all treatment pairs.
Results
We included 15 randomized studies comprising 102,974 patients across 10 interventions. NSAIDs evaluated were naproxen (n=17,185), ibuprofen (n=28,531), celecoxib (n=37,843), oral diclofenac (n=6,060), rofecoxib (n=804), nabumetone (n=15), valdecoxib (n=544), and amtolmetin guacil (n=30).
Compared with placebo, rofecoxib showed highest odds of renal AEs [OR: 5.11 (95% CI: 2.58–10.10)], naproxen showed highest odds of edema [OR: 2.08 (95% CI: 1.11-3.89)], and diclofenac showed highest odds of HTN [OR: 3.19 (95% CI: 2.13-4.80)]. NMA diagrams and league tables are shown in Figures.
Conclusion
Rofecoxib, naproxen, and diclofenac are associated with a higher incidence of renal AEs, edema, and HTN compared with placebo, respectively. Physicians should weigh renal safety when prescribing NSAIDs for arthritis.