Rheumatology

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COX-1–Sparing NSAIDs: What Do Small Lesions Mean?

KEY POINT

When patients’ GI tracts are viewed with endoscopes, the new COX-2 inhibitors are found to produce one-tenth as many small (3 mm) lesions as do older NSAIDs. But both old and new drugs produce clinical symptoms in similar numbers of patients, so the use of more expensive COX-2 inhibitors is focusing preferentially on those at high risk of GI problems.

SOURCES

Langman MJ et al. Adverse upper gastrointestinal effects of rofecoxib compared with NSAIDs. JAMA. 1999;282:1929–33.

Simon LS et al. Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis. JAMA. 1999;282:1921–6.

Peterson WL, Cryer B. COX-1–sparing NSAIDs—is the enthusiasm justified [editorial]? JAMA. 1999;282:1961–3.