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Why No Prescription Anti-Inflammatories for Life Extension?

cox inflammation

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#1 sub7

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Posted 06 April 2014 - 01:10 PM


I am far less knowledgeable than most members here, so you'll have to excuse my ignorance with this question.
However, I see a lot discussion about controlling inflammation for general health and well being. It does appear that, in general, anti-inflammatory substances are pro-health in very many ways and the majority (perhaps the vast, vast majority) of the population is over-inflamed. That being the case (please correct me if I am mistaken here), why isn't there much inclination to use -or at least consider- long term, low dose use of prescription anti-inflammatory medicines?

Say something like Melixocam at a low dose every day or every other day for very long periods for example... Would this be health promoting? Harmful...?

Let me proactively address some basics so we do not lose time discussing what should be obvious

- We need a certain amount of inflammation for health
Indeed we do. However, the aforementioned type of drugs are in any event not capable of eliminating all inflammation. Even corticosteroids cannot do that. Besides we are talking about low doses and these drugs cannot wipe out all inflammation at even far higher therapeutic dosages.

- Stomach Issues by Way of COX Inhibition
Yes, there may be some stomach problems if you inhibit all COX enzyme activity across the board for too long / too much. But Melixocam, especially at low doses, is COX-2 selective anyways. Besides, even chronically suppressing all types of COX by taking Aspirin is very safe - at low doses of course- for most people, even if you so do for decades.

Thank you in advance
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#2 niner

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Posted 06 April 2014 - 01:56 PM

Low dose aspirin is not just safe, it's positively beneficial. I wouldn't be surprised if other NSAIDs of the COX-inhibiting sort acted similarly, but we have data on long term low dose aspirin, and we don't have similar data on other anti-inflammatorys. Prescription drugs are much less likely to be widely used for long time periods- If they are off patent, yet not Over The Counter, then there is usually a reason. Either they are not viewed as safe enough to be used by knuckleheads, or they are such a small market drug that the company doesn't want to take them OTC because the overall process wouldn't be profitable.

To answer your question in another way, prescription anti-inflammatory drugs tend to be targeted to a specific inflammation pathway, and might miss other factors, and they tend to have problematic side effects. I think it's going to work out better to figure out what aspect of our lifestyle is causing the inflammation, and change it. For example, we could reduce our consumption of exogenous AGEs and other toxins.
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#3 sub7

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Posted 06 April 2014 - 02:46 PM

...prescription anti-inflammatory drugs tend to be targeted to a specific inflammation pathway, and might miss other factors...


Actually this can also be a huge advantage also. By selecting the correct drug one could -at least in theory- reduce only unwanted types of inflammation and leave desirable pathways (such as regeneration of the stomach lining) in place

Aspirin -if anything- has too broad an impact yet is still safe and beneficial over the long run
I would imagine a more narrowly targeted anti-inflammatory may have a better benefit/side effect ratio
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#4 nowayout

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Posted 06 April 2014 - 08:17 PM

Low dose aspirin is not just safe, it's positively beneficial.


Except, wasn't there a new study last year indicating that low dose aspirin increases risk of brain bleeds too much to be recommended for people without cardiovascular disease?
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#5 ceridwen

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Posted 06 April 2014 - 09:56 PM

I read in an old New Scientist that asprin can cause macular degeneration. I can't remember the edition. The other NSAIDs failed their trials for keeping neurodegeneration at bay. Don't know about aging itself but it is obviously not as promising as hoped for originally

#6 niner

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Posted 06 April 2014 - 10:05 PM

Low dose aspirin is not just safe, it's positively beneficial.


Except, wasn't there a new study last year indicating that low dose aspirin increases risk of brain bleeds too much to be recommended for people without cardiovascular disease?


I don't recall seeing it, but it does increase the risk of a brain bleed some. In the end it's a balance of risks problem, where one is trading off an increased risk of a brain bleed against a decreased risk of cancer. I shouldn't have gone as far as calling it "safe"- that was too simplistic. Hemorrhagic stroke is maybe 7-10% of all stroke, although it is more lethal in the acute phase. Aspirin increases the risk of it (from a brief search, it doesn't sound like much of an increase), and decreases the risk of ischemic events and at least some classes of cancer. There's also a risk of GI bleeds with NSAID use. My own choice is to use it at 81mg/d.

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#7 sub7

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Posted 07 April 2014 - 09:28 AM

DIscussion of Aspirin is good
But what about the broader question of using a COX subtype selective drug at low doses over the long run?

#8 maximum411

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Posted 07 April 2014 - 10:44 AM

I would be worried about a lack of muscle repair and growth on an anti-inflammatory. Inflammation is an important part of the muscle repair process, and indeed aspirin inhibits protein synthesis in muscle. I believe there is also evidence that NSAIDs like aspirin reduce antibody titer in response to vaccines.


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#9 niner

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Posted 07 April 2014 - 01:47 PM

I would be worried about a lack of muscle repair and growth on an anti-inflammatory. Inflammation is an important part of the muscle repair process, and indeed aspirin inhibits protein synthesis in muscle. I believe there is also evidence that NSAIDs like aspirin reduce antibody titer in response to vaccines.


That's a good point. Another example is repair of tendon injury- in a paper that was posted here a few years ago, rats with tendon injuries healed less well, resulting in a tendon that was less strong, under the influence of ibuprofen. I imagine that this is going to be a general problem of tissue remodeling, and is another example of why we wouldn't want to crush inflammation entirely. It's something that you need the right amount of, not none. All of the problems with anti-inflammatory drugs are likely to be dose-dependent, so this is a matter of getting the right dose for your situation. The "right dose" is undoubtedly zero for some people.
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#10 nowayout

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Posted 07 April 2014 - 02:36 PM

HAs it been mentioned yet that all the NSAIDs increase cardiovascular risk except for Naproxen? There is a nice comparative meta-study somewhere. So from the cardio point of view the safest ones would seem to be naproxen and aspirin.
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#11 Luminosity

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Posted 08 April 2014 - 06:15 AM

I don't know about prescription anti-inflammatories, but over the counter NSAIDS can cause liver and kidney damage, especially if you use them a lot.  I've seem people who do that develop weird wrinkles, too.  



#12 sub7

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Posted 08 April 2014 - 11:35 AM

I don't know about prescription anti-inflammatories, but over the counter NSAIDS can cause liver and kidney damage, especially if you use them a lot.  I've seem people who do that develop weird wrinkles, too.  

 

That is too broad a generalization

Only irresponsible use and/or pre-existing conditions would result in 'damage"

 

What kind of wrinkles? You mean wrinkles on the face?


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#13 Luminosity

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Posted 10 April 2014 - 05:21 AM

You're out of line.  I said "can cause liver and kidney damage" which is acknowledged by the manufacturers.  That is hardly too broad a statement.  Your other second sentence is just not true, is unsupported by any evidence, and contradicts what is known about these medicines.

 

Not at all sure your third line contains serious questions but yes, wrinkles on the face.   


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#14 Brett Black

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Posted 10 April 2014 - 08:40 AM

In male but not female mice, aspirin showed an 8% increase in median lifespan but a non-significant increase in maximum lifespan:

1. Aging Cell. 2008 Oct;7(5):641-50. doi: 10.1111/j.1474-9726.2008.00414.x.

Nordihydroguaiaretic acid and aspirin increase lifespan of genetically
heterogeneous male mice.

Strong R(1), Miller RA, Astle CM, Floyd RA, Flurkey K, Hensley KL, Javors MA,
Leeuwenburgh C, Nelson JF, Ongini E, Nadon NL, Warner HR, Harrison DE.

Author information:
(1)Geriatric Research, Education and Clinical Center and Research Service, South
Texas Veterans Health Care System, San Antonio, TX 78229, USA. strong@uthscsa.edu

The National Institute on Aging's Interventions Testing Program was established
to evaluate agents that are purported to increase lifespan and delay the
appearance of age-related disease in genetically heterogeneous mice. Up to five
compounds are added to the study each year and each compound is tested at three
test sites (The Jackson Laboratory, University of Michigan, and University of
Texas Health Science Center at San Antonio). Mice in the first cohort were
exposed to one of four agents: aspirin, nitroflurbiprofen,
4-OH-alpha-phenyl-N-tert-butyl nitrone, or nordihydroguaiaretic acid (NDGA).
Sample size was sufficient to detect a 10% difference in lifespan in either
sex,with 80% power, using data from two of the three sites. Pooling data from all
three sites, a log-rank test showed that both NDGA (p=0.0006) and aspirin
(p=0.01) led to increased lifespan of male mice. Comparison of the proportion of
live mice at the age of 90% mortality was used as a surrogate for measurement of
maximum lifespan;neither NDGA (p=0.12) nor aspirin (p=0.16) had a significant
effect in this test. Measures of blood levels of NDGA or aspirin and its
salicylic acid metabolite suggest that the observed lack of effects of NDGA or
aspirin on life span in females could be related to gender differences in drug
disposition or metabolism. Further studies are warranted to find whether NDGA or
aspirin, over a range of doses,might prove to postpone death and various
age-related outcomes reproducibly in mice.

PMCID: PMC2695675
PMID: 18631321 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm....pubmed/18631321


Edited by Brett Black, 10 April 2014 - 08:41 AM.

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