Selective vs. Nonselective NSAIDs in High-Risk Patients

Results from prospective randomized trials show that cyclooxygenase-2 (COX-2)-selective nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with fewer gastroduodenal ulcers and gastrointestinal complications than are nonselective NSAIDs. In stratified analyses, the difference in risk for complications between selective and nonselective NSAIDs appears greatest in patients at highest risk for NSAID-related complications. To determine the risk for upper GI bleeding in high-risk patients taking COX-2 selective NSAIDs, investigators in Denmark reviewed prescription and patient databases from the county of North Jutland (population, 493,000) for 36 months.

Using a case-control study design, they identified 780 patients with histories of G…