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March 1, 2006Journal of the Royal Society of MedicineOpen Access

Risk of Cardiovascular Events and Celecoxib: a Systematic Review and Meta-Analysis

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Why the study?

Does celecoxib increase the risk of myocardial infarction and other cardiovascular events compared to placebo or other analgesics?

Population

12,780 patients across 6 randomized double-blind clinical trials of at least 6 weeks' duration.

Comparison

Celecoxib vs Placebo or active comparators including…

Design

Meta-analysis, randomized, double-blind

Follow-up

at least 6 weeks

Authors

BCBrent CaldwellOklahoma State UniversitySASarah AldingtonAmbulance Service of New South WalesMWMark WeatherallCURE International UK

Discussion

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Overview

Supports restricting celecoxib in high cardiovascular-risk patients; confirms class effect of COX-2 inhibitors on myocardial infarction.

Structured PICO

Does celecoxib increase the risk of myocardial infarction and other cardiovascular events compared to placebo or other analgesics?

P
Population
12,780 patients across 6 randomized double-blind clinical trials of at least 6 weeks' duration (4,422 patients in 4 placebo-controlled trials for the primary analysis).
I
Intervention
Celecoxib
C
Comparator
Placebo (primary analysis) or active comparators including diclofenac, ibuprofen, and paracetamol (secondary analysis)
O
Outcome
Myocardial infarctionhard clinical

Celecoxib therapy is associated with an increased risk of myocardial infarction, suggesting a class effect for COX-2 specific inhibitors regarding cardiovascular toxicity.

Cite This Study

Caldwell et al. (2006) studied this question.

synapsesocial.com/papers/6a7f71a08cb2fb2788a6f433https://doi.org/10.1177/014107680609900315
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Are selective COX 2 inhibitors superior to traditional non steroidal anti-inflammatory drugs?2002 · 398 citations
  2. 2Systematic review of celecoxib for osteoarthritis and rheumatoid arthritis2003 · 24 citations
  3. 3COX-2 Inhibitors — A Lesson in Unexpected Problems2005 · 200 citations
  4. 4Quantifying heterogeneity in a meta‐analysis2002 · 37,581 citations
  5. 5Complications of the COX-2 Inhibitors Parecoxib and Valdecoxib after Cardiac Surgery2005 · 1,097 citations