The real advance, therefore, is natural or herbal coxibs
--wonder medicines, derived from nature--which have proved their worth for thousands of years, not to speak of availability and ease of use.
All NSAIDs, both coxib
and non-selective agents, confer an increased risk of thrombotic strokes and coronary events.
In particular, the rate of hip, pelvis, wrist, or humerus fractures was 101 per 1,000 person-years in the opioid group, compared with 19 per 1,000 person-years in the coxib
group and 26 per 1,000 person-years in the NSAID group.
We thus hypothesized that higher NT-proBNP concentrations might indicate greater cardiovascular risk when coxibs
were being used and, conversely, that lower concentrations would indicate lesser risk.
For one thing, proper cellular regeneration from certain types of soft tissue injuries can be blunted by coxibs
first became available in Britain a year ago for people suffering from osteoarthritis.
39: Leading brands in the global coxibs
market, 2006-07 118
, selective inhibitors of cyclooxygenase-2.
This puts the heart risks of generic NSAIDs on a par with a newer class of NSAIDs known as COX-2 inhibitors or coxibs
, which includes Vioxx - a painkiller that US drugmaker Merck pulled from sale in 2004 because of links to heart risks.
NSAIDs in combination with proton pump inhibitors (PPI), or coxibs
with or without PPI, may be used with caution.
are not only much more expensive than aspirin; they're relatively dangerous.
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
He concludes that studies on celecoxib and other NSAIDs have suggested that any risk with coxibs
is likely to be small and comparable to traditional NSAIDs.
Ravaud P, Tubach F (2005): Methodology of therapeutic trials: lessons from the late evidence of the cardiovascular toxicity of some coxibs
and Europe, support a significant limitation of our use of not only the coxibs
but the entire NSAID class.