BMJ  2005;331:1473-1474 (17 December), doi:10.1136/bmj.331.7530.1473-d

Letter

Risk of gastrointestinal effects with COX-2 inhibitors and NSAIDs

Study conclusions do not reflect findings for celecoxib

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

EDITOR—The conclusions drawn by Hippisley-Cox et al do not accurately reflect the data as presented.¹

This study found important differences between celecoxib and the studied non-steroidal anti-inflammatory drugs (NSAIDs) in terms of the risk of adverse gastrointestinal effects. Specifically, celecoxib was the only treatment that did not significantly increase the risk of such adverse events (adjusted relative risk 1.11, 95% confidence interval 0.87 to 1.41) compared with control patients. The authors comment that the number of patients taking celecoxib was low, yet the upper limit of the 95% CI for celecoxib is less than the lower limits for naproxen (1.73), diclofenac (1.78), other NSAIDs (1.43), and aspirin (1.49)—supporting the relative gastrointestinal safety of celecoxib.

The findings are consistent with the results of other studies. NSAIDs typically increase by twofold to fourfold the risks of a gastrointestinal bleed. For example, Mamdani et al studied 1.3 million elderly patients in . . . [Full text of this article]

Pfizer, New York, NY 10017, USA rscmoppgp-JoeFeczko@pfizer.com

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