COX-2 inhibitors prescribed to reduce gastrointestinal toxicity prior to the market w...( Nonsteroidal antiinflammatory drugs (N...),Health

Nonsteroidal antiinflammatory drugs (NSAIDs) have been the most popular treatment for arthritis despite their association with gastrointestinal (GI) complications, including bleeding ulcers and death. When selective cyclooxygenase 2 inhibitors (coxibs) were introduced a decade ago, they were widely hailed as a gastroprotective shield for NSAID users. Eventually, they were incorporated into the treatment guidelines of both the American College of Rheumatology and the Arthritis Foundation for patients at increased risk of GI complications.. Two gastroprotective strategies for patients prescribed NSAIDs were recommended--either coprescription of a non-selective NSAID with an acid-reducing medication or selection of a COX-2 inhibitor NSAID. Then, clinical studies began to uncover evidence that COX-2 inhibitors and other non-selective NSAIDs may increase the risk of heart attack and stroke. Spurred by these findings and other safety concerns, 2 of the 3 FDA-approved coxibs rofecoxib, known to consumers as Vioxx, and valdecoxib, known to consumers as Bextra were withdrawn from the market. Questions regarding the appropriate use of COX-2 inhibitors for arthritis patients and broader questions regarding prescribing patterns of novel drugs soon after FDA approval remain.

For answers, a study published in the August 2006 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examines the prescribing patterns of COX-2 inhibitors and other gastroprotective agents for arthritis patients with varying levels of GI risk. Using the Consortium of Rheumatology Researchers of North America (CORRONA) registry, a team of CORRONA investigators evaluated data on 2,690 rheumatoid arthritis (RA) patients treated between March 1, 2004 and September 30, 2004 the last day
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
27-Jul-2006