Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials
Why the study?
Do selective COX-2 inhibitors and traditional NSAIDs increase the risk of serious vascular events compared to placebo?
Population
Patients in randomized trials of at least four weeks' duration
Comparison
Selective cyclo-oxygenase-2 inhibitors or… vs Placebo or traditional NSAIDs (including naproxen)
Design
Meta-analysis
Follow-up
at least 4 weeks
Authors
Discussion
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Member takes
Implication
Supports avoiding selective COX-2 inhibitors in patients with cardiovascular risk; confirms increased serious vascular events in randomized meta-analysis.
Structured PICO
Do selective COX-2 inhibitors and traditional NSAIDs increase the risk of serious vascular events compared to placebo?
P
Population
Patients in randomized trials of at least four weeks' duration
I
Intervention
Selective cyclo-oxygenase-2 (COX 2) inhibitors or traditional non-steroidal anti-inflammatory drugs (NSAIDs) including high dose regimens of ibuprofen and diclofenac
C
Comparator
Placebo or traditional NSAIDs (including naproxen)
O
Outcome
Serious vascular events (composite of myocardial infarction, stroke, or vascular death)composite
Selective COX-2 inhibitors and high-dose regimens of ibuprofen and diclofenac are associated with a moderate increase in the risk of serious vascular events, whereas high-dose naproxen is not.
Cite This Study
Kearney et al. (2006) studied this question.