this was the argument after the VIGOR study - naproxen not ibuprofen in this
case - and I think there is truth in it but the APPROVE study (the one
leading to the withdrawal of rofecoxib) was against placebo. Rofecoxib was
clearly withdrawn for marketing reasons - MSD have another cox2 - but the
message I've taken from it is that I should be cautious about prescribing
NSAIDs where risk doesn't clearly outweigh benefit, which to me comes down
to inflammatory arthritis (where patients choose etc etc) and not OA/back
pain for most.
Lesley
-----Original Message-----
From: GP-UK [mailto:[log in to unmask]]On Behalf Of Adrian Midgley
Sent: 19 December 2004 14:52
To: [log in to unmask]
Subject: Re: After Vioxx, Celebrex
On Saturday 18 December 2004 16:25, Lesley Kay wrote:
> the real problem is that there has been no sufficiently large trial with
> conventional NSAIDs to show that they don't do it too...or aspirin for
that
> matter - how many cardiology trials have been longer than 18 months?
> Lesley
I thought it had been commonly accepted for some time that Ibuprofen etc
reduced the effectiveness of Aspirin at stopping MIs, while having some
activity in stopping MIs themselves.
To find that a COX2 has no activity at stopping MIs is unsurprising,
to find a COX2 doesn't stop MIs, while still antagonising the Aspirin
effect,
is interesting, but not surprising.
--
Adrian Midgley Open Source software is better
GP, Exeter http://www.defoam.net/
Why this sig: http://www.defoam.net/whysig.txt
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