Gastrointestinal Tolerability of the Selective Cyclooxygenase-2 (COX-2) Inhibitor Rofecoxib Compared With Nonselective COX-1 and COX-2 Inhibitors in Osteoarthritis

Watson, Douglas J.; Harper, Sean E.; Zhao, Peng-Liang; Quan, Hui; Bolognese, James A.; Simon, Thomas

doi:10.1001/archinte.160.19.2998

Cited by 149 publications

(69 citation statements)

References 18 publications

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“…The coxibs are not without adverse events. Dyspepsia has been reported with coxib use, although at lower rates than those reported with NSAID use (23,24). In theory, coxibs may affect renal function in the same way as NSAIDs.…”

Section: Introductionmentioning

confidence: 96%

Use of NSAIDs, COX‐2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population

Rahme

Marentette

Kong

et al. 2002

Arthritis & Rheumatism

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Section: Introductionmentioning

confidence: 96%

Use of NSAIDs, COX‐2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population

Rahme

Marentette

Kong

et al. 2002

Arthritis & Rheumatism

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“…When compared to traditional nonselective NSAIDs, such as naproxen and ibuprofen, selective COX-2 agents (coxibs) achieve equal pain relief while reducing upper-GI dyspeptic symptoms by 15%. 48 The Arthritis Pain Society 4 recently endorsed coxibs as the drug class of choice for the initial management of moderate to severe arthritis pain, although COX-2 selective agents cost considerably more than the nonselective NSAIDs. Studies considering the increased cost of the selective agents in relation to their improved safety profile suggest that these agents may eventually dominate the nonselective NSAID arthritic pain management strategy of treatment only if the cost per coxib tablet is reduced by nearly 90%.…”

Section: Nsaids Categoriesmentioning

confidence: 99%

“…The use of celecoxib/Celebrex is associated with a lower incidence of symptomatic ulcers and ulcer complications compared with conventional NSAIDs in non-aspirin users. 41,48 However, there is evidence that both COX-1-and COX-2-derived prostaglandins are involved in gastric cytoprotective mechanisms. 36,41,47 Recent studies describe the constitutive expression of COX-2 in healthy human and animal gastric mucosa.…”

Section: Cox-2 Specific Nsaidsmentioning

confidence: 99%

Pharmacology in Rehabilitation: Nonsteroidal Anti-inflammatory Agents

Biederman¹

2005

J Orthop Sports Phys Ther

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Nonsteroidal anti-inflammatory agents (NSAIDs) are the most commonly encountered over-thecounter (OTC) and prescription medications in physical therapy practice. Worldwide, over 73 000 000 prescriptions for nonsteroidal agents are written yearly. NSAIDs produce a wide range of beneficial effects to the physical therapy patient, enhancing the outcome of treatment. Helpful effects of NSAIDs include analgesia, antipyretic, anti-inflammatory, and antithrombotic properties. However, NSAIDs are also associated with frequent and significant side effects that are deleterious to treatment outcome, including delay in soft tissue and bone healing, renal and liver toxicity, hemorrhagic events, gastric irritation and ulceration, and central nervous system effects. Understanding of the pharmacological properties of these drugs, exemplified by aspirin, and the individual pharmacokinetics of specific preparations will help the therapist to screen patients for potential side effects, develop more effective plans of care, and, where allowed, effectively and safely prescribe NSAIDs. J Orthop Sports Phys Ther 2005;35:356-367.

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“…76,77 For both celecoxib and rofecoxib, discontinuation rates due to GI adverse effects are lower than for other NSAIDs; however, the clinical importance of these differences is questionable since COX-2 inhibitors still appear to cause a significant amount of dyspepsia and abdominal pain, and the absolute magnitude of any COX-2 benefit is small (NNT to prevent 1 case of dyspepsia = 50-60 patients for 6 months).…”

Section: Tolerabilitymentioning

confidence: 99%

Review of the selective COX-2 inhibitors celecoxib and rofecoxib: focus on clinical aspects

Loewen

2002

CJEM

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The selective cyclooxygenase-2 (COX-2) inhibitors celecoxib and rofecoxib were designed to have similar efficacy but less gastrointestinal toxicity than traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Their efficacy has been demonstrated in the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, postoperative dental pain and dysmenorrhea. These agents produce fewer endoscopic ulcers, symptomatic ulcers and gastrointestinal bleeds than traditional NSAIDs; although the absolute benefit is small and the gastropreserving effect is negated by concurrent use of low-dose aspirin for cardiovascular risk reduction. Nephrotoxicity and hyptertension remain concerns with COX-2 inhibitors, as they are with traditional NSAIDs. COX-2 inhibitors may be safe alternatives to traditional NSAIDs for patients with aspirin-sensitive asthma. RÉSUMÉLes inhibiteurs sélectifs de la cyclo-oxygénase-2 (COX-2) célécoxib et rofécoxib ont été conçus pour agir de manière aussi efficace que les anti-inflammatoires non stéroïdiens (AINS) traditionnels, mais avec moins de toxicité gastro-intestinale. Ils se sont révélés efficaces dans le traitement de l'arthrose, de l'arthrite rhumatoïde, de la spondylarthrite ankylosante, de la dentalgie post-chirurgicale et de la dysménorrhée. Ces agents provoquent moins d'ulcères endoscopiques, d'ulcères symptomatiques et de saignements gastro-intestinaux que les AINS traditionnels; cependant, le bienfait absolu est faible et l'effet de gastro-préservation est annulé par le recours concomitant à de l'aspirine à faible dose pour la réduction du risque cardiovasculaire. La néphrotoxicité et l'hypertension demeurent une préoccupation avec les inhibiteurs de la COX-2, tout comme avec les AINS traditionnels. Les inhibiteurs de la COX-2 peuvent se révéler une solution de rechange sécuri-taire aux AINS traditionnels chez les patients atteints d'asthme hypersensible à l'aspirine.

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Gastrointestinal Tolerability of the Selective Cyclooxygenase-2 (COX-2) Inhibitor Rofecoxib Compared With Nonselective COX-1 and COX-2 Inhibitors in Osteoarthritis

Abstract: Rofecoxib was associated with a lower incidence of treatment discontinuations due to GI AEs over 12 months and a lower incidence of dyspeptic-type GI AEs over 6 months than treatment with nonselective COX inhibitors, or NSAIDs. Arch Intern Med. 2000;160:2998-3003

Cited by 149 publications

References 18 publications

Use of NSAIDs, COX‐2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population

Use of NSAIDs, COX‐2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population

Pharmacology in Rehabilitation: Nonsteroidal Anti-inflammatory Agents

Review of the selective COX-2 inhibitors celecoxib and rofecoxib: focus on clinical aspects

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