Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group.

@article{Bombardier2000ComparisonOU,
  title={Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group.},
  author={Claire Bombardier and Loren Laine and A Reicin and Deborah R. Shapiro and Rub{\'e}n Burgos-Vargas and Barry Davis and Richard O Day and Marcos Bosi Ferraz and Christopher J. Hawkey and Marc C. Hochberg and Tore K. Kvien and Thomas J. Schnitzer},
  journal={The New England journal of medicine},
  year={2000},
  volume={343 21},
  pages={
          1520-8, 2 p following 1528
        }
}
BACKGROUND Each year, clinical upper gastrointestinal events occur in 2 to 4 percent of patients who are taking nonselective nonsteroidal antiinflammatory drugs (NSAIDs). We assessed whether rofecoxib, a selective inhibitor of cyclooxygenase-2, would be associated with a lower incidence of clinically important upper gastrointestinal events than is the nonselective NSAID naproxen among patients with rheumatoid arthritis. METHODS We randomly assigned 8076 patients who were at least 50 years of… Expand
Serious lower gastrointestinal clinical events with nonselective NSAID or coxib use.
TLDR
Serious lower GI events occurred at a rate of 0.9% per year in rheumatoid arthritis patients taking the nonselective NSAID naproxen, accounting for nearly 40% of the serious GI events that developed in these patients. Expand
Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison
TLDR
There were significantly fewer upper gastrointestinal clinical events with the COX-2 selective inhibitor etoricoxib than with the traditional NSAID diclofenac due to a decrease in uncomplicated events, but not in the more serious complicated events. Expand
Incidence of gastroduodenal ulcers in patients with rheumatoid arthritis after 12 weeks of rofecoxib, naproxen, or placebo: a multicentre, randomised, double blind study
TLDR
Rofecoxib 50 mg daily (twice the dose recommended for this patient population) resulted in a lower incidence of endoscopically detected gastroduodenal ulcers and erosions than treatment with naproxen 500 mg twice daily. Expand
Gastrointestinal tolerability of lumiracoxib in patients with osteoarthritis and rheumatoid arthritis.
TLDR
Lumiracoxib exhibited a gastrointestinal safety profile superior to nonselective nonsteroidal anti-inflammatory drugs, and the cumulative frequency of ulcers >or=3 mm in diameter was reduced by >70% for lumirac oxib versus ibuprofen. Expand
Gastrointestinal Tolerability and Effectiveness of Rofecoxib versus Naproxen in the Treatment of Osteoarthritis
TLDR
A pooled analysis of 8 efficacy trials in osteoarthritis and a large prospective study of outcomes in rheumatoid arthritis showed that rofecoxib maintained efficacy and resulted in a significantly lower incidence of serious GI toxicity compared with nonspecific dual COX inhibitors. Expand
Risks of clinically significant upper gastrointestinal events with etodolac and naproxen: a historical cohort analysis.
TLDR
Etodolac is a generic COX-2 selective inhibitor that reduces CSUGI events compared with the nonselective NSAID naproxen, however, concomitant use of low-dose aspirin negates the gastrointestinal safety advantages of etodolaf. Expand
Stratifying the risk of NSAID-related upper gastrointestinal clinical events: results of a double-blind outcomes study in patients with rheumatoid arthritis.
TLDR
NSAID-related GI events increase dramatically with risk factors such as prior events or older age, and ten to twelve high-risk patients need to be treated with a protective strategy such as the selective cyclooxygenase 2 inhibitor, rofecoxib, to avert a clinical GI event. Expand
Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial
TLDR
Risk of clinical outcomes throughout the gastrointestinal tract was lower in patients treated with a COX-2-selective NSAID than in those receiving a non-selectives NSAID plus a PPI, and should encourage review of approaches to reduce risk of NSAID treatment. Expand
Gastrointestinal tolerability of etoricoxib in rheumatoid arthritis patients: results of the etoricoxib vs diclofenac sodium gastrointestinal tolerability and effectiveness trial (EDGE-II).
TLDR
Etoricoxib 90 mg demonstrated a significantly lower risk for discontinuing treatment due to GI AEs compared with diclofenac 150 mg, and resulted in similar efficacy. Expand
Management of gastroduodenal ulcers and gastrointestinal symptoms associated with nonsteroidal anti-inflammatory drug therapy : A summary of four comparative trials with omeprazole, ranitidine, misoprostol, and placebo
TLDR
Omeprazole was more effective in healing and prophylaxis of NSAID-associated gastroduodenal ulceration and symptoms than misoprostol and ranitidine in chronic NSAID users, and was better tolerated than misobrostol. Expand
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