COX-2: where are we in 2003?--distinction from NSAIDs becoming blurred
- PMID: 12723976
- PMCID: PMC165043
- DOI: 10.1186/ar747
COX-2: where are we in 2003?--distinction from NSAIDs becoming blurred
Abstract
The distinction between cyclooxygenase-2-selective inhibitors (CSIs) and nonsteroidal anti-inflammatory drugs ultimately must be clinical and must be clinically and economically relevant. This distinction needs to be demonstrated in a substantial and clinically relevant difference in the respective rates of serious adverse reactions of the upper gastrointestinal tract. Event-driven, randomized, blinded, controlled trials with sufficient power are required to resolve uncertainties concerning the relative risk of thrombotic cardiovascular events in patients taking CSIs who have risk factors for these events. Patients and situations more representative of those in primary-care practice - elderly, comorbidities, comedication - need to be included in larger studies to provide a better understanding of the risks and benefits of CSIs.
References
-
- Brooks P, Emery P, Evans JF, Fenner H, Hawkey CJ, Patrono C, Smolen J, Breedveld F, Day R, Dougados M, Ehrich EW, Gijon-Banos J, Kvien TK, Van Rijswijk MH, Warner T, Zeidler H. Interpreting the clinical significance of the differential inhibition of cyclooxygenase-1 and cyclooxygenase-2. Rheumatology. 1999;38:779–788. doi: 10.1093/rheumatology/38.8.779. - DOI - PubMed
-
- Bombardier C, Laine L, Reicin A, Shapiro D, Burgos-Vargas R, Davis B, Day R, Ferraz MB, Hawkey CJ, Hochberg MC, Kvien TK, Schnitzer TJ. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med. 2000;343:1520–1530. doi: 10.1056/NEJM200011233432103. - DOI - PubMed
-
- Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, Makuch R, Eisen G, Agrawal NM, Stenson WF, Burr AM, Zhao WW, Kent JD, Lefkowith JB, Verburg KM, Geis GS. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomized controlled trial. JAMA. 2000;284:1247–1255. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Research Materials
