COX-2 inhibitors do not protect the stomach

Reported by Susan Aldridge, PhD, medical journalist

A study suggests that the new generation of non-steroidal anti-inflammatory agents is no less harmful to the stomach lining.
The COX-2 inhibitors are newer versions of non-steroidal anti-inflammatory agents (NSAIDs) which are supposed to be freer of side effects on the gastrointestinal tract. Conventional NSAIDs like aspirin can irritate the stomach lining and cause bleeding. But NSAIDs are valuable in treating arthritis and in protecting against heart attack, stroke and maybe even cancer. This is why the COX-2 inhibitors were developed - to give the benefits with fewer of the risks.

A team at the University of Nottingham, UK, now describes a study which looks at a group of 9407 patients with an ulcer or gastrointestinal bleed. Each patient was compared to a matched group of 10 control patients. Prescriptions for NSAIDs, including aspirin, in the previous three years were identified.

Of the group with the gastrointestinal problem, nearly half had been on a conventional NSAID during the three years and 10 per cent had taken a COX-2 inhibitor. In the control group, 33 per cent were on a conventional NSAID and six per cent on a COX-2 inhibitor. The study showed that there was an increased risk of gastrointestinal problems with both types of drug. From this study, then, it looks as if the COX-2 inhibitors might not live up to their safety claims.

Source
British Medical Journal 3rd December 2005 Volume 331 pages 1310-1312

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