Efficacy and safety of COX 2 inhibitors

doi:10.1136/bmj.325.7365.607

BMJ 2002;325:607-608 ( 21 September )

Editorials

Efficacy and safety of COX 2 inhibitors

New data are encouraging but the risk:benefit ratio remains unclear

Papers pp 619, 624

The first 150 words of the full text of this article appear below.

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain and improve function in people with mechanical and inflammatoryarthropathies and are beneficial in many other conditions, butthese benefits come at a price. In the United Kingdom, every yearover 2000 people die as a result of upper gastrointestinal damageinduced by NSAIDs, and these agents can also have unwanted effectson the lower bowel, lungs, kidneys, and cardiovascular system.Conversely, some NSAIDs may have useful antithrombotic actionsand increasing evidence shows that they may inhibit the developmentof colonic neoplasia and other gastrointestinal cancers.^1-3 Theintroduction of new anti-inflammatory agents, with more specificinhibitory effects on cyclo-oxygenase 2 (COX 2) pathways, promisedequivalent efficacy with greater safety andtolerability.

Two large pivotal trials have been published, in which the efficacy and safety of the COX 2 inhibitors celecoxib and rofecoxibwere compared with various traditional NSAIDs. Unfortunately thecelecoxib long term arthritis safety study (CLASS),⁴ . . . [Full text of this article]

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This article has been cited by other articles:

Sooriakumaran, P (2006). COX-2 inhibitors and the heart: are all coxibs the same?. Postgrad. Med. J. 82: 242-245 [Abstract] [Full text]
Lewis, M. R, Kay, D. (2005). Risk of gastrointestinal effects with COX-2 inhibitors and NSAIDs: COX-2 inhibitors were thought of as a safe option. BMJ 331: 1474-1474 [Full text]
Hippisley-Cox, J., Coupland, C., Logan, R. (2005). Risk of adverse gastrointestinal outcomes in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ 331: 1310-1316 [Abstract] [Full text]
Hippisley-Cox, J., Coupland, C. (2005). Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ 330: 1366- [Abstract] [Full text]
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(2002). Celecoxib: Equally Efficacious, Less GI Toxic Than Other NSAIDs. Journal Watch Dermatology 2002: 9-9 [Full text]
(2002). Celecoxib: Equally Efficacious, Less GI Toxic Than Other NSAIDs. JWatch General 2002: 3-3 [Full text]

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