Limits...
Selective COX-2 inhibitors, NSAIDs and cardiovascular events - is celecoxib the safest choice?

Howes LG - Ther Clin Risk Manag (2007)

Bottom Line: However, subsequent data have suggested an association between therapy with non-selective COX inhibitors (NSAIDs) and serious cardiovascular events.Celecoxib therapy may be associated with an increased risk of cardiovascular events, but only when used at doses substantially higher than those recommended for the treatment of arthritis.There is a greater body of evidence supporting the relative cardiovascular safety of celecoxib when used at the doses recommended for the treatment of arthritis than for any of the other selective COX-2 inhibitors or NSAIDs.

View Article: PubMed Central - PubMed

Affiliation: Departments of Cardiology, and Pharmacology and Therapeutics, Gold Coast Hospital, Griffith University Medical School Southport, Queensland, Australia.

ABSTRACT
Inhibitors of cyclo-oxogenase (COX) are widely used anti-inflammatory drugs. In recent years concerns have arisen about the cardiovascular safety of these drugs, initially because of reported associations between therapy with the COX-2 selective inhibitor rofecoxib and myocardial infarction. However, subsequent data have suggested an association between therapy with non-selective COX inhibitors (NSAIDs) and serious cardiovascular events. This article reviews the clinical trial and population data linking COX inhibition to cardiovascular events. The data currently available suggests that both specific and non-specific COX inhibitors may increase the risk of serious cardiovascular events, but that the effect varies between the individual drugs. The strongest evidence for an increased risk of serious cardiovascular events is with rofecoxib therapy. Celecoxib therapy may be associated with an increased risk of cardiovascular events, but only when used at doses substantially higher than those recommended for the treatment of arthritis. There is a greater body of evidence supporting the relative cardiovascular safety of celecoxib when used at the doses recommended for the treatment of arthritis than for any of the other selective COX-2 inhibitors or NSAIDs.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence of serious cardiovascular events on celecoxib compared to the combined NSAID group (Upper Panel A) and compared to the individual results for ibuprofen and diclofenac (Lower Panel B).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2376081&req=5

fig3: Cumulative incidence of serious cardiovascular events on celecoxib compared to the combined NSAID group (Upper Panel A) and compared to the individual results for ibuprofen and diclofenac (Lower Panel B).

Mentions: It is of interest to examine the cardiovascular events that occurred on celecoxib therapy compared to the individual NSAIDS studied, ibuprofen and diclofenac. The rate of accumulation of adverse cardiovascular events during the CLASS study for each of the drugs used is presented in Figure 3. In the top part of the Figure (A), the celecoxib group and both NSAIDS combined data are compared, while in the bottom part of the Figure (B) celecoxib and the individual NSAIDS are compared.


Selective COX-2 inhibitors, NSAIDs and cardiovascular events - is celecoxib the safest choice?

Howes LG - Ther Clin Risk Manag (2007)

Cumulative incidence of serious cardiovascular events on celecoxib compared to the combined NSAID group (Upper Panel A) and compared to the individual results for ibuprofen and diclofenac (Lower Panel B).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376081&req=5

fig3: Cumulative incidence of serious cardiovascular events on celecoxib compared to the combined NSAID group (Upper Panel A) and compared to the individual results for ibuprofen and diclofenac (Lower Panel B).
Mentions: It is of interest to examine the cardiovascular events that occurred on celecoxib therapy compared to the individual NSAIDS studied, ibuprofen and diclofenac. The rate of accumulation of adverse cardiovascular events during the CLASS study for each of the drugs used is presented in Figure 3. In the top part of the Figure (A), the celecoxib group and both NSAIDS combined data are compared, while in the bottom part of the Figure (B) celecoxib and the individual NSAIDS are compared.

Bottom Line: However, subsequent data have suggested an association between therapy with non-selective COX inhibitors (NSAIDs) and serious cardiovascular events.Celecoxib therapy may be associated with an increased risk of cardiovascular events, but only when used at doses substantially higher than those recommended for the treatment of arthritis.There is a greater body of evidence supporting the relative cardiovascular safety of celecoxib when used at the doses recommended for the treatment of arthritis than for any of the other selective COX-2 inhibitors or NSAIDs.

View Article: PubMed Central - PubMed

Affiliation: Departments of Cardiology, and Pharmacology and Therapeutics, Gold Coast Hospital, Griffith University Medical School Southport, Queensland, Australia.

ABSTRACT
Inhibitors of cyclo-oxogenase (COX) are widely used anti-inflammatory drugs. In recent years concerns have arisen about the cardiovascular safety of these drugs, initially because of reported associations between therapy with the COX-2 selective inhibitor rofecoxib and myocardial infarction. However, subsequent data have suggested an association between therapy with non-selective COX inhibitors (NSAIDs) and serious cardiovascular events. This article reviews the clinical trial and population data linking COX inhibition to cardiovascular events. The data currently available suggests that both specific and non-specific COX inhibitors may increase the risk of serious cardiovascular events, but that the effect varies between the individual drugs. The strongest evidence for an increased risk of serious cardiovascular events is with rofecoxib therapy. Celecoxib therapy may be associated with an increased risk of cardiovascular events, but only when used at doses substantially higher than those recommended for the treatment of arthritis. There is a greater body of evidence supporting the relative cardiovascular safety of celecoxib when used at the doses recommended for the treatment of arthritis than for any of the other selective COX-2 inhibitors or NSAIDs.

No MeSH data available.


Related in: MedlinePlus