The incidences of upper gastrointestinal clinical events have been shown to be significantly less with COX-2 selective inhibitors than traditional NSAIDs in randomised gastrointestinal outcomes trials of 12 weeks - 12 months' duration.
COX-2 selective inhibitors have also been reported to induce less dyspepsia than traditional NSAIDs.
In this trial the authors set out to compare the upper gastrointestinal safety of COX-2 selective inhibitors versus traditional NSAIDs in a way that simulated standard clinical practice.
From a clinical perspective, the effectiveness of COX-2 selective inhibitors, in terms of antiinflammatory activity and pain relief, are comparable to those effects of NS-NSAIDs, at least in the studies that have been used as pivotal for approval.
66) Preliminary evidence also suggests overall reduced GI complications with the COX-2 selective inhibitors compared with NS-NSAIDs, even with concomitant use of proton pump inhibitors.
Collectively, these studies demonstrate significantly reduced GI complications with COX-2 selective inhibitors, compared with NS-NSAIDs, and a reduction in potential fatalities resulting from GI complications.
It is also unknown whether the COX-2 selective inhibitors will demonstrate these same effects although studies show that agents in these drug classes may have different effects from each other, possibly unrelated to prostaglandin inhibition.