Rofecoxib Is Associated with Fewer GI Complications than Naproxen

Gastroduodenal ulcers and bleeding are the most common complications of therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Drugs that selectively inhibit the COX-2 isoform of cyclooxygenase are thought to be equally effective but do not impair the protective gastric mechanisms that depend upon COX-1. Recent data suggest that endoscopic ulcers are less frequent with COX-2 selective inhibitors than with nonselective drugs (see JW Gastro Feb 2000, p. 2, accession number 000201004, and JAMA 1999; 282:1921, 1929). Endoscopic ulcers, however, are only a surrogate marker for clinical events. To examine the clinical safety of the COX-2 selective NSAID rofecoxib, investigators randomized 8076 patients with rheumatoid arthritis to receive ei…