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Review: studies on the cardiovascular effects of selective COX-2 inhibitors show mixed results

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 QUESTION: In patients with arthritis, do rofecoxib or celecoxib increase the risk for cardiovascular events?

Data sources

Studies were identified by searching Medline (1998 to February 2001) and the internet. The Adverse Events Reporting System was searched for US events on October 12, 2000.

Study selection

English language studies were selected if they were randomised, double blind, controlled trials reporting the cardiovascular effects of celecoxib or rofecoxib.

Data extraction

Data were extracted on study methods, patient characteristics, drug regimens, aspirin use, and cardiovascular events.

Main results

4 studies met the selection criteria. The Vioxx Gastrointestinal Outcomes Research study compared rofecoxib 50 mg/day, with naproxen 1000 mg/day, in 8076 patients with rheumatoid arthritis. Aspirin use was not permitted. Patients in the rofecoxib group had an increased risk for …

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  • * Numbers calculated from data in article

  • Source of funding: not stated.

  • For correspondence: Dr E J Topol, Cleveland Clinic Foundation, Cleveland, OH, USA. topole{at}