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Selectivity of NSAIDs for COX-2 and Cardiovascular Outcome

Overview
Journal Br J Clin Pharmacol
Specialty Pharmacology
Date 2006 Jul 18
PMID 16842401
Citations 1
Authors
S R J Maxwell
R A Payne
G D Murray
D J Webb
Affiliations
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Abstract

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) with increased selectivity for the cyclooxygenase-2 (COX-2) isoform reduce gastrotoxicity but may increase adverse cardiovascular events.

Methods: We searched the literature for studies that reported the odds ratio (OR) for such events following exposure to NSAIDs.

Results: For studies comparing NSAID use with no use, increased COX-2 selectivity was significantly related to cardiovascular risk (log OR) amongst observational studies (R = -0.34, P < 0.001) and randomized controlled trials (RCTs) (R = -0.56, P < 0.001). For studies comparing NSAIDs, difference in selectivity was related to risk for observational studies (R = -0.28, P = 0.005) but not for RCTs (R = -0.23, P = 0.15).

Conclusions: Although increased COX-2 selectivity may reduce gastrotoxicity, this may be at the cost of increasing cardiovascular risk.

Citing Articles

Clinical Pharmacology and Cardiovascular Safety of Naproxen.

Angiolillo D, Weisman S Am J Cardiovasc Drugs. 2016; 17(2):97-107.

PMID: 27826802 PMC: 5340840. DOI: 10.1007/s40256-016-0200-5.

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