GI Toxicity of Rofecoxib vs. Naproxen

Endoscopic studies have shown that COX-2 inhibitors induce less asymptomatic gastroduodenal ulceration than do traditional NSAIDs. Whether this translates into fewer symptomatic ulcers was controversial until a recent trial demonstrated a lower incidence of symptomatic or complicated ulcers with celecoxib than with ibuprofen or diclofenac (JW Oct 15 2000, p. 159, accession number 000922001, and JAMA 2000; 284:1247). But what about rofecoxib, the other available COX-2 inhibitor?

In a double-blind, randomized, multicenter trial sponsored by the manufacturer, 8076 patients with rheumatoid arthritis received either rofecoxib (50 mg daily) or naproxen (500 mg twice daily). Patients requiring aspirin therapy were excluded. During an average follow…