Major Finding: Opioid users had higher rates of overall adverse events, severe adverse events, cardiovascular events, fractures, and all-cause mortality than did NSAID users or coxib
In laboratory studies, University of Michigan researchers found that several coxibs
, the drug class to which Celebrex belongs, interfere with aspirin's ability to discourage blood clots, if the aspirin is taken in low doses.
However, studies with newer NSAIDs such as the selective COX-2 inhibitors (also called coxibs
) have resulted in concern that there might be an increase in the risk of heart attack, thrombosis or stroke associated with long-term, high-dosage use of coxibs
Accordingly, as an initial test we evaluated this strategy with samples from a small study of coxib
use that prospectively identified cardiovascular adverse events (CV-AEs).
When co-morbidity factors are present, coxibs
should be used only as needed, and in doses lower than previously thought.
From a GI bleeding-risk perspective, a coxib
makes a better choice.
Table 1: Coxibs
currently on the market Generic Name Originator Any Indication etoricoxib Merck & Co Arthritis, osteo Arthritis, rheumatoid Pain, musculoskeletal Pain, post-operative Dysmenorrhoea celecoxib Pfizer Arthritis, rheumatoid Arthritis, osteo Pain, musculoskeletal valdecoxib Pfizer Arthritis, rheumatoid Arthritis, osteo Pain, musculoskeletal Dysmenorrhoea parecoxib sodium Pfizer Pain, post-operative
New use of a nonselective NSAID, coxib
, or an opioid was determined by excluding persons who received these drugs in the 180 days before the index date.
The sponsors of MEDAL programme (4) conducted an analysis of 3 RCTs to assess the safety of etoricoxib (the newest coxib
on the market) versus diclofenac in 34 701 patients with arthritis.
This is now a phenomenon that I think is greater than a coxib
issue, even though we clearly had the first signs from a coxib
," he said.
Prof Thomas Schnitzer, Professor of Rheumatology and Assistant Dean for Clinical Research at Northwestern University Feinberg School of Medicine in Chicago, Co-Chairman of NicOx's CAB and a Principal Investigator in the phase II clinical program of AZD3582 stated: "These results fully support the clinical efficacy of AZD3582 and provide encouraging data to support the value of this compound in reducing or even possibly eliminating some of the most serious side effects of NSAID and coxib
Like those medications, Deramaxx belongs to the coxib
class of non-steroidal anti-inflammatory drugs (NSAIDs).