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Etoricoxib, a highly selective cyclooxygenase-2 (COX-2) inhibitor, is licensed in several European countries and has an application pending in the U.S. In recently published randomized trials funded and largely conducted by its maker (Journal Watch Nov 28 2006), etoricoxib was compared with diclofenac, an older, less selective nonsteroidal anti-inflammatory drug; the two drugs had similar analgesic and cardiovascular effects in arthritis patients. Now, the same authors report on the gastrointestinal outcomes of these trials.
Nearly 35,000 patients with osteoarthritis or rheumatoid arthritis received either etoricoxib or diclofenac for an average of 18 months. Patients at increased risk for cardiovascular disease or upper GI events were urged…