COX-2 Selective Nonsteroidal Anti-inflammatory Drugs and Risk of Gastrointestinal Tract Complications and Myocardial Infarction

Davies, Neil M; Smith, George Davey; Windmeijer, Frank; Martin, Richard M.

doi:10.1097/ede.0b013e318289e024

Cited by 38 publications

(47 citation statements)

References 53 publications

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“…However, increasing evidences demonstrating that selective COX-2 inhibitors have the risks to cause greater potential for heart attacks [6–8], strokes and other cardiovascular problems [9,10]. Studies suggested that administration of selective COX-2 inhibitors soon after injury, while providing desired analgesic effects, may attenuate wound healing in many tissues [11] and are associated with a significantly higher incidence of wound infections [12].…”

Section: Introductionmentioning

confidence: 99%

The Adverse Effect of Selective Cyclooxygenase-2 Inhibitor on Random Skin Flap Survival in Rats

et al. 2013

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BackgroundCyclooxygenase-2(COX-2) inhibitors provide desired analgesic effects after injury or surgery, but evidences suggested they also attenuate wound healing. The study is to investigate the effect of COX-2 inhibitor on random skin flap survival.MethodsThe McFarlane flap model was established in 40 rats and evaluated within two groups, each group gave the same volume of Parecoxib and saline injection for 7 days. The necrotic area of the flap was measured, the specimens of the flap were stained with haematoxylin-eosin(HE) for histologic analysis. Immunohistochemical staining was performed to analyse the level of VEGF and COX-2 .Results7 days after operation, the flap necrotic area ratio in study group (66.65±2.81)% was significantly enlarged than that of the control group(48.81±2.33)%(P <0.01). Histological analysis demonstrated angiogenesis with mean vessel density per mm2 being lower in study group (15.4±4.4) than in control group (27.2±4.1) (P <0.05). To evaluate the expression of COX-2 and VEGF protein in the intermediate area II in the two groups by immunohistochemistry test .The expression of COX-2 in study group was (1022.45±153.1), and in control group was (2638.05±132.2) (P <0.01). The expression of VEGF in the study and control groups were (2779.45±472.0) vs (4938.05±123.6)(P <0.01).In the COX-2 inhibitor group, the expressions of COX-2 and VEGF protein were remarkably down-regulated as compared with the control group.ConclusionSelective COX-2 inhibitor had adverse effect on random skin flap survival. Suppression of neovascularization induced by low level of VEGF was supposed to be the biological mechanism.

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Section: Introductionmentioning

confidence: 99%

The Adverse Effect of Selective Cyclooxygenase-2 Inhibitor on Random Skin Flap Survival in Rats

et al. 2013

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“…[1][2][3][4][5][6] This is partly because instrumental variable analyses have the potential to overcome some of the issues associated with conventional statistical approaches, such as residual confounding and reverse causation. As the demand to provide power calculations to support applications increases, there is a more pressing need to be able to provide power calculations for this method.…”

Section: Introductionmentioning

confidence: 99%

Power calculator for instrumental variable analysis in pharmacoepidemiology

Walker

Davies

Windmeijer

et al. 2016

Preprint

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Abstract Background: Instrumental variable analysis, for example with physicians' prescribing preferences as an instrument for medications issued in primary care, is an increasingly popular method in the field of pharmacoepidemiology. Existing power calculators for studies using instrumental variable analysis, such as Mendelian randomization power calculators, do not allow for the structure of research questions in this field. This is because the analysis in pharmacoepidemiology will typically have stronger instruments and detect larger causal effects than in other fields. Consequently, there is a need for dedicated power calculators for pharmacoepidemiological research. Methods and Results: The formula for calculating the power of a study using instrumental variable analysis in the context of pharmacoepidemiology is derived before being validated by a simulation study. The formula is applicable for studies using a single binary instrument to analyse the causal effect of a binary exposure on a continuous outcome. An online calculator, as well as packages in both R and Stata, are provided for the implementation of the formula by others. Conclusions: The statistical power of instrumental variable analysis in pharmacoepidemiological studies to detect a clinically meaningful treatment effect is an important consideration. Research questions in this field have distinct structures that must be accounted for when calculating power. The formula presented differs from existing instrumental variable power formulae due to its parametrization, which is designed specifically for ease of use by pharmacoepidemiologists.

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“…Recent research outlines the promise an IV analysis. Davies et al find IV estimates that are consistent with the results from randomized trials, while estimates based on the assumption of no unmeasured confounding contradict the results from the trials. Imbens and Rosenbaum provide a particularly lucid justification for the use of instruments: The goal is to replace the implausible assumption of selection on observables with the more plausible, though not certain, IV assumptions.…”

Section: A Brief Review and Defense Of Instrumental Variablesmentioning

confidence: 86%