COX-2 Selective NSAIDs Not Always Easier on Your Stomach
March 10, 2004
OTTAWA — Not all COX-2 selective NSAIDs are safer than traditional NSAIDs concludes a recent systematic review by the Canadian Coordinating Office for Health Technology Assessment (CCOHTA).
Non-steroidal anti-inflammatory drugs, or NSAIDs, are commonly used to relieve pain from arthritic and inflammatory disorders. However, these drugs can produce serious side effects such as stomach ulcers. COX-2 selective NSAIDs have been heavily marketed based on their lower rate of gastrointestinal side effects.
The lead author of CCOHTA’s report, Dr. Alaa Rostom, emphasizes the range of differing gastrointestinal toxicities within the NSAID family of drugs. “While COX-2 selective NSAIDs overall are safer for the stomach and better tolerated than traditional NSAIDs, we have to look closely at the individual drugs.
“The evidence indicates meloxicam may not be any easier on the stomach than less expensive traditional NSAIDs,” Dr. Rostom says. “Celecoxib appears to be no safer than diclofenac, a commonly used traditional NSAID. And while rofecoxib has not undergone the same formal comparison, data from a subset of patients suggests it may also be no safer than diclofenac.
“We await the results of several ongoing studies of newer more COX-2- selective NSAIDs and encourage pharmaceutical companies to compare their product to traditional NSAIDS such as diclofenac and ibuprofen,” Dr. Rostom says.
Gastro-intestinal side effects are an important clinical issue because of the widespread and increasing use of NSAIDs. In 2001, sales of traditional NSAIDs exceeded $150 million (5.4 million prescriptions), while the sales of COX 2 NSAIDs climbed to over $450 million (7.7 million prescriptions)
CCOHTA is an independent, not-for-profit organization that provides unbiased, reliable information about health technologies. CCOHTA manages a health technology assessment program and the Common Drug Review program. Funding is provided by the Canadian federal, provincial and territorial governments.
This Technology Overview is available online
The full assessment (Technolgy Report) is available online
For further information contact Kirk Fergusson: 613 226-2553 ext. 276