COX-2 inhibitors do not offer GI benefit over other NSAIDs
Cyclo-oxygenase-2 inhibitors do not offer enhanced protection against gastrointestinal (GI) events, compared with non-selective non-steroidal anti-inflammatory drugs (NSAIDs), a case-control study suggests (BMJ 2005;331:1310).
The researchers matched 9,407 patients with a first-ever diagnosis of
an adverse upper GI event with 88,867 controls. When adjusted for confounders,
the odds ratio for an adverse upper GI event was raised for current use
of many of the NSAIDs, compared with that for patients who had received
no prescriptions for any of the drugs in the previous three years. Raised
odds ratios were found for rofecoxib (1.56, 95 per cent confidence interval
1.30–1.87), naproxen (2.12, 1.73–2.58), diclofenac (1.96,
1.78–2.15), aspirin (1.60, 1.49–1.72), and ibuprofen (1.42,
1.27–1.59). No significantly increased risk was found for current
use of celecoxib (1.11, 0.87–1.41), although the number of patients
taking celecoxib was small.
“
We were concerned to find an increased risk of adverse GI outcomes among
patients taking rofecoxib, since a lower risk of adverse GI outcomes
was one of the main justifications for its use,” the authors comment. “Although
rofecoxib has recently been withdrawn, our analysis provides no evidence
of enhanced GI safety for the other cyclo-oxygenase-2 inhibitors for
which current usage on individual agents is low.” |
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