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- W1987992337 abstract "In today's Lancet, Loren Laine and colleagues compare the effect of selective versus non-selective cyclo-oxygenase (COX) inhibition on the prevalence of upper gastrointestinal clinical events. 1 Laine L Curtis SP Cryer B Kaur A Cannon CP for the MEDAL Steering CommitteeAssessment 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. Lancet. 2007; 369: 465-473 Summary Full Text Full Text PDF PubMed Scopus (201) Google Scholar This analysis is important because non-selective COX inhibitors, such as diclofenac, are notorious for causing upper gastrointestinal symptoms, such as (bleeding) ulcers, by depleting cytoprotective mucosal prostaglandins. 2 Hawkey CJ Langman MJ Non-steroidal anti-inflammatory drugs: overall risks and management: complementary roles for COX-2 inhibitors and proton pump inhibitors. Gut. 2003; 52: 600-608 Crossref PubMed Scopus (165) Google Scholar The development of selective COX-2 inhibitors was heralded as a tremendous advance, because these drugs pair a strong anti-inflammatory effect with low gastrointestinal toxicity. 3 Moore RA Derry S Phillips CJ McQuay HJ Nonsteroidal anti-inflammatory drugs (NSAIDs), cyxlooxygenase-2 selective inhibitors (coxibs) and gastrointestinal harm: review of clinical trials and clinical practice. BMC Musculoskelet Disord. 2006; 7: 79 Crossref PubMed Scopus (106) Google Scholar Indeed, the divergent side-effect profile from traditional COX inhibitors became an important subject for study. 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 comparisonThere 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. The reduction in uncomplicated events with etoricoxib is maintained in patients treated with PPIs and is also observed with regular low-dose aspirin use. Full-Text PDF" @default.
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- W1987992337 date "2007-02-01" @default.
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- W1987992337 title "Do COX-2 inhibitors give enough gastrointestinal protection?" @default.
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- W1987992337 doi "https://doi.org/10.1016/s0140-6736(07)60206-2" @default.
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