Studies: COX2 Inhibitors Cause Fewer Gastrointestinal Complications

Selective COX2 inhibitors, which are widely used for treatment of osteoarthritis and rheumatoid arthritis, appear to cause fewer gastrointestinal complications than conventional non-steroidal anti-inflammatory drugs (NSAIDs), according to two studies reported in the British Medical Journal.

Long-term use of NSAIDs is linked with the development of peptic and duodenal ulcers. Selective COX2 inhibitors such as celecoxib (Celebrex) and refecoxib (Vioxx) are thought to cause fewer gastrointestinal problems than conventional, non-selective NSAIDs.

Researchers at Oxford reviewed all trials of the safety and effectiveness of celecoxib and found it to be as effective as other NSAIDs and less likely to cause problems such as ulcers. The improvement in gastrointestinal safety was still evident in patients who were also taking aspirin.

A second study by researchers in Toronto compared the rates of upper gastrointestinal hemorrhage in elderly users of the COX2 inhibitors rofecoxib and celecoxib with those of users of other NSAIDs and a group who didn't use NSAIDs at all. The conventional NSAID used in this study was diclofenac plus misoprostol (Arthrotec).

Researchers found that the risk of hemorrhage with the COX2 inhibitors was significantly lower than with conventional NSAIDs. But, the risk with rofecoxib was significantly higher than that with celecoxib. For patients taking celecoxib, the risk was about the same as that of the group who didn't take NSAIDs at all.

Other sources: British Medical Journal