Q: I am a 35 years old male has been diagnosed with ankylosing spondylitis and prescribed to take Etoricoxib (120 mg) everyday. My recent lipid profile showed HDL-27, LDL-70, VLDL-37 and triglycerides-212. My HDL is low because of heredity and triglycerides often go above 200. Considering my poor lipid profile, can using Etoricoxib for long term cause cardiac problems?

A:While treating any disease the treating physician takes a balanced approach carefully weighing the beneficial effects of a certain form of treatment against the adverse effects of that treatment. On balance, the available scientific evidence indicates that continuous treatment (not ‘on-demand’ – only take it for pain) seems to halt the progression of the disease - ankylosing spondylitis – at its root in approximately 60-70% of the patients. More interestingly, suppression of disease activity is also known (through many other studies) to reduce the chances of early heart disease. This needs to be balanced against the reported increased risk of heart disease with coxibs (the class of drugs to which etoricoxib belongs). An important point related to lipid profile now-a-days is much less emphasis on HDL-cholesterol and much more emphasis on LDL-cholesterol and triglycerides. If the LDL-C level is targeted to 70 mg/dL or lower, and triglycerides less than 150 mg/dL – much of these heart-related issues are taken care of. There are wonderful drugs available to achieve this target.