Selectivity of NSAIDs for COX-2 and cardiovascular outcome

S. R. J. Maxwell*, R. A. Payne, G. D. Murray, D. J. Webb

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aims 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.

Original languageEnglish
Pages (from-to)243-245
Number of pages3
JournalBritish Journal of Clinical Pharmacology
Volume62
Issue number2
DOIs
Publication statusPublished - Aug 2006

Keywords

  • NSAID
  • coxib
  • cardiovascular
  • myocardial infarction
  • COX-2 selectivity
  • NONSTEROIDAL ANTIINFLAMMATORY DRUGS
  • INHIBITORS
  • PROSTACYCLIN
  • LESSONS

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