January DTB slates coxibs
Few, if any, situations exist in which a coxib should be prescribed in preference to traditional non-steroidal anti-inflammatory drugs, according to the latest issue of the Drug
and Therapeutics Bulletin (2005;43:1).
The bulletin examined the trial evidence and safety data for highly selective
cyclooxygenase-2 inhibitors (coxibs) in light of the recent withdrawal
of rofecoxib (Vioxx). It concludes that the added gastroprotective benefits
of coxibs are marginal at best.
Although coxibs may be less likely than conventional NSAIDs to cause
dyspeptic symptoms and appear to cause fewer endoscopically visible erosions,
long-term studies have failed to demonstrate advantages in terms of severe
ulcer complications.
On top of this, the DTB continues, any benefits of coxibs are outweighed
by potential cardiovascular safety concerns.
Ike Iheanacho, editor of the DTB, commented: “With mounting evidence
that coxibs may cause severe cardiovascular problems, it is hard to justify
using these treatments in preference to the older drugs.”
The January issue of DTB also reviews use of probiotics for atopic diseases
(ibid, p6). |
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