Study: NSAIDs, COX-2 inhibitors Have Equivalent Side Effects

Researchers in Scotland found that in a trial involving more tha n 7,000 patients, the rates of adverse cardiac and other negative outcomes were about the same whether these patients took NSAIDs or COX-2 inhibitors.

In older patients with no history of cardiovascular disease, physicians can prescribe non-steroidal anti-inflammatory drugs [NSAIDs] without being concerned that they are more likely to cause harm than cyclooxygenase-2 (COX-2) inhibitors. Earlier studies have raised concerns about COX-2 inhibitors’ cardiovascular side effects when taken regularly for arthritis.

Reporting at the European Society of Cardiology meeting in London, UK, Thomas MacDonald, MD of the University of Dundee in Scotland said the Standard care versus Celecoxib Outcome Trial (SCOT) showed the two types of drugs were equivalent when it came to these side effects.

The trial included more than 7,000 subjects in primary care taking NSAIDS.

Patients were age 60 or older, had not cardiovascular disease, and were taking the drugs for osteoarthritis or rheumatoid arthritis.

They were randomized to non-selective NSAIDs or COX-2 inhibitors and followed for three years.

The percentages of subjects in group who experienced adverse cardiac outcomes was similar: 1.8% of the COX-2 group and 2.2% of the NSAID group.

The study also found that ulcer-related gastrointestinal events were rare in both groups .

But both groups had serious adverse effects—5.2% of the COX-2 group and 5.8% of the NSAID group.