The results showed that of those currently using a COX-2 inhibitor
, 19% were more likely to die after a stroke than those who didn't take the drug and new users of the medicines had a 42% increase in risk mortality from stroke compared to nonusers.
Compared with people who did not take the drugs, recent users were about 40% more likely to suffer irregular heart beat if they were on NSAIDs and 70% more likely if they were on COX-2 inhibitors
The researchers found that use of NSAIDs or COX-2 inhibitors
was associated with an increased risk of atrial fibrillation or flutter.
During the period spanned by our data (1999-2002), the two available COX-2 inhibitors
were Vioxx and Celebrex.
The objective was to determine the impact of PAR for COX-2 inhibitors
on prescription expenditures and prescribing patterns in a Medicaid program.
Between 1997 and 2004, the gap between NSAID prescriptions and gastroprotective therapies steadily decreased (from 79% to 14% of patients on NSAIDs who were not getting gastroprotection), in large part due to increased use of COX-2 inhibitors
beginning in 1999.
To test whether thwarting COX-2 would have an effect on mice predisposed to pancreatic cancer, the researchers fed chow containing a COX-2 inhibitor
called nimesulide to mice harboring the Kras mutation.
Following an exhaustive review of systematic reviews and meta-analyses, the authors conclude that COX-2 inhibitors
are contraindicated in patients with ischaemic heart disease or stroke.
If further relief is needed, physicians should suggest the least selective COX-2 inhibitors
first, moving progressively toward more selective COX-2 inhibitors
, which are at the bottom of the list, only if needed.
Vioxx, which is part of a group of anti-inflammatories known as COX-2 inhibitors
, was banned in 2004 after it was shown that patients on the drug were more than twice as likely to have heart attacks as those not taking it.
When all "vascular events" - heart attacks, stroke, or vascular disease - were taken together, the risks increased by 40pc on COX-2 inhibitors
Three studies of COX-2 inhibitors
have shown that administration of a COX-2 inhibitor
is associated with a reduction in polyps in high-risk patients.
But the extent to which use of Cox-2 inhibitors
increase the risk of cardiovascular events has been the subject of considerable debate in the past two years.
All NSAIDs, including the COX-2 inhibitors
, work by blocking the actions of the COX-1 and COX-2 enzymes.
CANADA -- A study of more than a million patients over 66 years of age showed that the number of hospitalizations for upper gastrointestinal (GI) bleeding increased after more people started taking certain anti-inflammatory medications called COX-2 inhibitors