Fewer Lower GI Events with COX-2 Inhibitors Than with NSAIDs

Nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) are known to induce small bowel and colonic ulcers and strictures, to be associated with other lower gastrointestinal complications such as diverticulitis, and, because of their antiplatelet effects, to induce bleeding from lesions unrelated to NSAIDs (such as cancers and angiodysplasia). In contrast, the effects of selective cyclooxygenase-2 (COX-2) inhibitors on lower GI complications are uncertain.

In this study (supported by the manufacturer of rofecoxib), researchers performed a blinded, post-hoc analysis of lower GI complications in the widely known, prospective VIGOR trial, in which 8076 patients (aged 50 or older) with rheumatoid arthritis were randomized to receive rofecoxib…