Article Text

Download PDFPDF
Taking stock of coxibs
  • Relevant BNF section: 10.1.1


Highly selective COX-2 inhibitors ('coxibs') were developed in an attempt to minimise severe gastrointestinal toxicity associated with conventional NSAIDs, without loss of anti-inflammatory efficacy. Five years ago, we concluded that the evidence then available indicated, at most, a small advantage for rofecoxib and celecoxib (the first coxibs to be marketed) over conventional NSAIDs in terms of reduced risk of severe gastrointestinal complications, such as bleeding or perforation of gastric or duodenal ulcers.1 In September 2004, newly released evidence about cardiovascular risk with rofecoxib led Merck Sharp & Dohme to voluntarily withdraw the drug worldwide.2 This has raised questions about the balance of benefit and risk with coxibs in general. Here we discuss the evidence relating to the gastrointestinal and cardiovascular safety of coxibs in patients with osteoarthritis (OA) or rheumatoid arthritis (RA).

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

  • Relevant BNF section: 10.1.1

View Full Text