Key result
Selective COX-2 inhibitors were associated with a lower short-term risk of upper gastrointestinal hemorrhage compared with non-selective NSAIDs (adjusted rate ratio 4.4 for NSAIDs vs celecoxib).
Why the study?
Do selective COX-2 inhibitors reduce the risk of upper gastrointestinal haemorrhage compared to non-selective NSAIDs in elderly patients?
Population
143,969 NSAID-naive subjects aged ≥66 years
Comparison
Selective COX-2 inhibitors vs Non-selective NSAIDs, diclofenac plus…
Design
Cohort
Follow-up
short term
Authors
Loading...
May support short-term celecoxib preference to lower GI bleed risk in elderly; leaves open causal confirmation in RCTs.
Cohort (n=143,969)
Do selective COX-2 inhibitors reduce the risk of upper gastrointestinal haemorrhage compared to non-selective NSAIDs in elderly patients?
Effect estimate: RR 4.4 (95% CI 2.3 to 8.5)
In elderly patients, selective COX-2 inhibitors (particularly celecoxib) are associated with a lower short-term risk of upper gastrointestinal hemorrhage compared to non-selective NSAIDs.
Mamdani et al. (2002) conducted a cohort in NSAID-naive elderly patients (n=143,969). Selective COX-2 inhibitors (rofecoxib, celecoxib) vs. Non-selective NSAIDs, diclofenac plus misoprostol, and no NSAIDs was evaluated on hospital admission for upper gastrointestinal haemorrhage (RR 4.4, 95% CI 2.3 to 8.5). Selective COX-2 inhibitors were associated with a lower short-term risk of upper gastrointestinal hemorrhage compared with non-selective NSAIDs (adjusted rate ratio 4.4 for NSAIDs vs celecoxib).
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: