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Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with gastrointestinal bleeding in 2% of patients annually. NSAIDs that selectively inhibit the COX-2 isoenzyme of cyclooxygenase, such as rofecoxib and celecoxib, may reduce this risk. Three industry-supported studies address this issue.
Researchers in the first study randomized 742 patients with osteoarthritis to receive daily doses of rofecoxib (25 or 50 mg), ibuprofen (2400 mg), or placebo. The cumulative incidence of new endoscopic ulcers at 12 weeks was 4.1% for 25-mg rofecoxib group, 7.3% for 50-mg rofecoxib group, 27.7% for the ibuprofen group, and 9.9% for the placebo group. At 24 weeks, the ulcer rates in the 3 treatment groups were 9.6%, 14.7%, 45.8%, respectively (P<0.05…