August 22, 2001JAMA
Risk of Cardiovascular Events Associated With Selective COX-2 Inhibitors
Why the study?
Do selective COX-2 inhibitors increase the risk of cardiovascular events in patients with arthritis and musculoskeletal pain without coronary artery disease?
Population
Patients with arthritis and musculoskeletal pain without coronary artery disease. Includes data from VIGOR…
Comparison
Selective COX-2 inhibitors (rofecoxib, celecoxib) vs Nonsteroidal anti-inflammatory agents and…
Design
Systematic_review
Authors
Discussion
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Member takes
Implication
Raises caution against rofecoxib in arthritis; confirms cardiovascular hazard of selective COX-2 inhibitors and supports restricted use.
Structured PICO
Do selective COX-2 inhibitors increase the risk of cardiovascular events in patients with arthritis and musculoskeletal pain without coronary artery disease?
P
Population
Patients with arthritis and musculoskeletal pain without coronary artery disease. Includes data from VIGOR (n=8076), CLASS (n=8059), and 2 smaller trials (~1000 patients each).
I
Intervention
Selective COX-2 inhibitors (rofecoxib, celecoxib)
C
Comparator
Nonsteroidal anti-inflammatory agents (naproxen in VIGOR, unspecified NSAIDs in CLASS) and historical placebo from a primary prevention meta-analysis
O
Outcome
Thrombotic cardiovascular events (composite of myocardial infarction, unstable angina, cardiac thrombus, resuscitated cardiac arrest, sudden or unexplained death, ischemic stroke, and transient ischemic attacks in VIGOR; myocardial infarction, stroke, and death in CLASS)safety
Selective COX-2 inhibitors are associated with an increased risk of thrombotic cardiovascular events, raising a significant cautionary flag for their clinical use.
Cite This Study
Debabrata Mukherjee (2001) studied this question.