Iatrogenic Effects of COX-2 Inhibitors in the US Population

  title={Iatrogenic Effects of COX-2 Inhibitors in the US Population},
  author={Rhema Vaithianathan and Peter M. Hockey and Thomas J. Moore and D. Bates},
  journal={Drug Safety},
AbstractBackground: Selective cyclo-oxygenase 2 inhibitors (‘coxibs’) have been demonstrated to increase cardiovascular risk, but the cumulative burden of adverse effects in the US population is uncertain. Objective: To quantify cardiovascular and gastrointestinal (GI) haemorrhage disease burden from coxibs and traditional ‘non-selective’ non-steroidal anti-inflammatory drugs (t-NSAIDs) in the US population. Design, setting and participants: Adult respondents from the 1999–2003 Medical… 

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NSAID use is not associated with an increased risk of incident myocardial infarction and HF but is associated with a reduction in all-cause mortality in Australian veterans.

Adverse effects of nonsteroidal antiinflammatory drugs: an update of gastrointestinal, cardiovascular and renal complications.

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Selective inhibition of cyclooxygenase-2: risks and benefits.

The mechanisms underlying the cardiovascular effects are discussed, pointing out the advantages and disadvantages of the selective or nonselective COX inhibitors.

Inibição seletiva da ciclo-oxigenase-2: riscos e benefícios

The mechanisms underlying the cardiovascular effects are discussed, pointing out the advantages and disadvantages of the selective or nonselective COX inhibitors.

Cyclooxygenase Inhibition and P 2 Y 12 Antagonism

Its evolution as a mainstay of cardioprotection illustrates interlocking contributions of industry and academia, the importance of astute clinical observation, and the pivotal integration of basic and clinical pharmacology in drug repurposing, prompting hypotheses then addressed by large, placebo-controlled, randomized trials.

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Prostanoids and NSAIDs in Cardiovascular Biology and Disease

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Cyclooxygenase-2 Selective Nonsteroidal Anti-Inflammatory Drugs and the Risk of Ischemic Stroke: A Nested Case-Control Study

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Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial.

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Within months of rofecoxib’s approval in May 1999, the Vioxx Gastrointestinal Outcomes Research (VIGOR) trial reported a 50% reduction in serious gastrointestinal outcomes, but a 5-fold increase in thromboembolic cardiovascular events (primarily acute myocardial infarction [MI]) among patients treated with 50 mg/d of roFECoxib compared with 1000 mg/D of naproxen.

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Channelling bias and the incidence of gastrointestinal haemorrhage in users of meloxicam, coxibs, and older, non-specific non-steroidal anti-inflammatory drugs

After attempting to correct for channelling bias, coxib exposure, but not meloxicam exposure, was associated with a significantly lower risk of gastrointestinal haemorrhage than older non-specific NSAIDs exposure.

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