A New COX-2 Inhibitor Is No More Cardiotoxic Than an Older NSAID

Since the controversy over rofecoxib (Vioxx), uncertainty has persisted about the relative cardiac risks of selective cyclo-oxygenase-2 (COX-2) inhibitors and traditional, nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). In three related trials that were funded and largely conducted by Merck, investigators randomized more than 34,000 patients with osteoarthritis or rheumatoid arthritis to receive either the highly selective COX-2 inhibitor etoricoxib (licensed in many countries, application pending in the U.S.) or the older NSAID diclofenac, for an average of 18 months. Patients at increased risk for cardiovascular disease or upper gastrointestinal events were encouraged to take low-dose aspirin or anti-ulcer agents, respectively…