Journal ArticleDOI
Risk of cardiovascular events associated with selective COX-2 inhibitors.
TLDR
The results from VIGOR showed that the relative risk of developing a confirmed adjudicated thrombotic cardiovascular event with rofecoxib treatment compared with naproxen was higher than that in the placebo group of a recent meta-analysis of 23 407 patients in primary prevention trials.Abstract:
Atherosclerosis is a process with inflammatory features and selective
cyclooxygenase 2 (COX-2) inhibitors may potentially have antiatherogenic effects
by virtue of inhibiting inflammation. However, by decreasing vasodilatory
and antiaggregatory prostacyclin production, COX-2 antagonists may lead to
increased prothrombotic activity. To define the cardiovascular effects of
COX-2 inhibitors when used for arthritis and musculoskeletal pain in patients
without coronary artery disease, we performed a MEDLINE search to identify
all English-language articles on use of COX-2 inhibitors published between
1998 and February 2001. We also reviewed relevant submissions to the US Food
and Drug Administration by pharmaceutical companies.Our search yielded 2 major randomized trials, the Vioxx Gastrointestinal
Outcomes Research Study (VIGOR; 8076 patients) and the Celecoxib Long-term
Arthritis Safety Study (CLASS; 8059 patients), as well as 2 smaller trials
with approximately 1000 patients each. The results from VIGOR showed that
the relative risk of developing a confirmed adjudicated thrombotic cardiovascular
event (myocardial infarction, unstable angina, cardiac thrombus, resuscitated
cardiac arrest, sudden or unexplained death, ischemic stroke, and transient
ischemic attacks) with rofecoxib treatment compared with naproxen was 2.38
(95% confidence interval, 1.39-4.00; P = .002). There
was no significant difference in cardiovascular event (myocardial infarction,
stroke, and death) rates between celecoxib and nonsteroidal anti-inflammatory
agents in CLASS. The annualized myocardial infarction rates for COX-2 inhibitors
in both VIGOR and CLASS were significantly higher than that in the placebo
group of a recent meta-analysis of 23 407 patients in primary prevention
trials (0.52%): 0.74% with rofecoxib (P = .04 compared
with the placebo group of the meta-analysis) and 0.80% with celecoxib (P = .02 compared with the placebo group of the meta-analysis).The available data raise a cautionary flag about the risk of cardiovascular
events with COX-2 inhibitors. Further prospective trial evaluation may characterize
and determine the magnitude of the risk.read more
Citations
More filters
Journal ArticleDOI
2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology.
Gilles Montalescot,Udo Sechtem,Stephan Achenbach,Felicita Andreotti,Chris Arden,Andrzej Budaj,Raffaele Bugiardini,Filippo Crea,Thomas Cuisset,Carlo Di Mario,J. Rafael Ferreira,Bernard J. Gersh,Anselm K. Gitt,Jean-Sébastien Hulot,Nikolaus Marx,Lionel H. Opie,Matthias Pfisterer,Eva Prescott,Frank Ruschitzka,Manel Sabaté,Roxy Senior,David P. Taggart,Ernst E. van der Wall,Christiaan J. Vrints,José Luis Zamorano,Helmut Baumgartner,Jeroen J. Bax,Héctor Bueno,Veronica Dean,Christi Deaton,Çetin Erol,Robert Fagard,Roberto Ferrari,David Hasdai,Arno W. Hoes,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Patrizio Lancellotti,Aleš Linhart,Petros Nihoyannopoulos,Massimo F Piepoli,Piotr Ponikowski,Per Anton Sirnes,Juan Tamargo,Michal Tendera,Adam Torbicki,William Wijns,Stephan Windecker,Marco Valgimigli,Marc J. Claeys,Norbert Donner-Banzhoff,Herbert Frank,Christian Funck-Brentano,Oliver Gaemperli,José Ramón González-Juanatey,Michalis Hamilos,Steen Husted,Stefan James,Kari Kervinen,Steen Dalby Kristensen,Aldo P. Maggioni,Axel R. Pries,Francesco Romeo,Lars Rydén,Maarten L. Simoons,Ph. Gabriel Steg,Adam Timmis,Aylin Yildirir +68 more
TL;DR: The If Inhibitor Ivabradine in Patients With Coronary Artery Disease and Left Ventricular Dysfunction is evaluated as well as patients with Diabetes mellitus for Optimal management of Multivessel disease.
Journal ArticleDOI
Therapeutic potential of resveratrol: the in vivo evidence.
Joseph A. Baur,David A. Sinclair +1 more
TL;DR: A comprehensive and critical review of the in vivo data on resveratrol is provided, and its potential as a therapeutic for humans is considered.
Journal ArticleDOI
Cyclooxygenase Isozymes: The Biology of Prostaglandin Synthesis and Inhibition
TL;DR: Characterization of the two COX isozymes is allowing the discrimination of the roles each play in physiological processes such as homeostatic maintenance of the gastrointestinal tract, renal function, blood clotting, embryonic implantation, parturition, pain, and fever.
Journal ArticleDOI
OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis
Raveendhara R. Bannuru,Mikala C. Osani,Elizaveta E. Vaysbrot,Nigel K Arden,Nigel K Arden,Kim L Bennell,Sita M A Bierma-Zeinstra,Virginia B. Kraus,L.S. Lohmander,J.H. Abbott,Mohit Bhandari,Francisco J. Blanco,R. Espinosa,Ida K. Haugen,J. Lin,Lisa A. Mandl,Eeva Moilanen,Norimasa Nakamura,Lynn Snyder-Mackler,Thomas H. Trojian,Malcolm J. Underwood,Malcolm J. Underwood,Timothy E. McAlindon +22 more
TL;DR: These guidelines offer comprehensive and patient-centered treatment profiles for individuals with Knee, Hip, and Polyarticular OA that are derived from expert consensus and based on objective review of high-quality meta-analytic data.
Journal ArticleDOI
The management of persistent pain in older persons.
Bruce A. Ferrell,D. Casarett,J. Epplin,P. Fine,F. M. Gloth,Keela Herr,P. R. Katz,Francis J. Keefe,P. J.S. Koo,M. O'Grady,P. Szwabo,A. H. Vallerand,D. Weiner +12 more
TL;DR: This guideline was developed and written under the auspices of the American Geriatrics Society (AGS) Panel on Persistent Pain in Older Persons and approved by the AGS Board of Directors on April 8, 2002.
References
More filters
Journal ArticleDOI
Effects of an angiotensin-converting -enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients
TL;DR: Ramipril significantly reduces the rates of death, myocardial infarction, and stroke in a broad range of high-risk patients who are not known to have a low ejection fraction or heart failure.
Journal ArticleDOI
Blood pressure, stroke, and coronary heart disease: Part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context
Rory Collins,Richard Peto,Stephen MacMahon,Patricia R. Hebert,N H Fiebach,Kimberley Eberlein,Jon Godwin,Nawab Qizilbash,James O. Taylor,Charles H. Hennekens +9 more
TL;DR: A sufficiently high risk of stroke (perhaps because of age, blood pressure, or, in particular, history of cerebrovascular disease) may be the clearest indication for antihypertensive treatment.
Journal ArticleDOI
Comparison of Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen in Patients with Rheumatoid Arthritis
Claire Bombardier,Loren Laine,Alise S. Reicin,Deborah R. Shapiro,Ruben Burgos-Vargas,Barry R. Davis,Richard O. Day,Marcos Bosi Ferraz,Christopher J. Hawkey,Marc C. Hochberg,Tore K Kvien,Thomas J. Schnitzer +11 more
TL;DR: In patients with rheumatoid arthritis, treatment with rofecoxib, a selective inhibitor of cyclooxygenase-2, is associated with significantly fewer clinically important upper gastrointestinal events than treatment with naproxen, a nonselective inhibitor.
Journal ArticleDOI
Gastrointestinal Toxicity With Celecoxib vs Nonsteroidal Anti-inflammatory Drugs for Osteoarthritis and Rheumatoid Arthritis: The CLASS Study: A Randomized Controlled Trial
Fred E. Silverstein,Gerald A. Faich,Jay L. Goldstein,Lee S. Simon,Theodore Pincus,Andrew Whelton,Robert W. Makuch,Glenn M. Eisen,Naurang M. Agrawal,William F. Stenson,Aimee M. Burr,William W. Zhao,Jeffrey D. Kent,James B. Lefkowith,Kenneth M. Verburg,G. Steven Geis +15 more
TL;DR: In this study, celecoxib, at dosages greater than those indicated clinically, was associated with a lower incidence of symptomatic ulcers and ulcer complications combined, as well as other clinically important toxic effects, compared with NSAIDs at standard dosages.
Journal ArticleDOI
TIS10, a phorbol ester tumor promoter-inducible mRNA from Swiss 3T3 cells, encodes a novel prostaglandin synthase/cyclooxygenase homologue
TL;DR: The expression of the TIS10 gene appears to be highly cell type-restricted in cultured cell lines; of 12 cell lines tested under superinducing conditions, only the rodent embryonic Swiss 3T3 and Rat1 cell lines expressed TIS12 gene.