Do COX-2 Inhibitors Cause Less Mucosal Damage than NSAIDs?
The annual incidence of clinically important gastrointestinal complications resulting from therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) approaches 2 percent in patients with arthritis. Endoscopic studies of such patients suggest that the incidence of NSAIDinduced gastroduodenal ulcers ranges from 15 to 30 percent. Cyclooxygenase-2 (COX-2) inhibitors appear to have fewer gastrointestinal side effects than NSAIDs. Hawkey and associates conducted a comparative study of the gastrointestinal effects of the COX-2 inhibitor rofecoxib, ibuprofen and placebo in patients with osteoarthritis. The randomized double-blind study included 775 patients who were assigned to one of four treatment groups: 800 mg of ibuprofen three times daily (193 patients), 25 mg of rofecoxib daily (195 patients), 50 mg of rofecoxib daily (193 patients) and placebo (194 patients). The duration of therapy was 16 to 24 weeks. Baseline endoscopic examination was performed in all patients after they had disco
