ReviewCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2002
The double-edged sword of COX-2 selective NSAIDs.
Review in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 6 syntheses or guidelines pooled it, 146 citations in OpenAlex.
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- Systematic Review and Meta-Analysis of the Association Between Non-Steroidal Anti-Inflammatory Drugs and Operative Bleeding in the Perioperative Period.Journal of the American College of Surgeons · 2021Pooled it
- Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis.BMC complementary medicine and therapies · 2020Pooled it
- Risk of Bleeding with Exposure to Warfarin and Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review and Meta-Analysis.Thrombosis and haemostasis · 2020Pooled it
- Glucosamine therapy for treating osteoarthritis.The Cochrane database of systematic reviews · 2005Pooled it
- Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo controlled trials.BMJ (Clinical research ed.) · 2004Pooled it
- Scheduled Intravenous Acetaminophen Improves Patient Satisfaction With Postcraniotomy Pain Management: A Prospective, Randomized, Placebo-controlled, Double-blind Study.Journal of neurosurgical anesthesiology · 2018Trial
- A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee.International journal of medical sciences · 2011Trial
- Comparative efficacy and tolerability of 5-Loxin and AflapinAgainst osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study.International journal of medical sciences · 2010Trial
- A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee.Arthritis research & therapy · 2008Trial
- Exploring the Cardiovascular Safety Profile of Ibuprofen: Insights from EudraVigilance Database.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Sustained delivery of celecoxib from nanoparticles embedded in hydrogel injected into the biopsy cavity to prevent biopsy-induced breast cancer metastasis.Breast cancer research and treatment · 2024Article
- Article
- A standardizedFrontiers in pharmacology · 2024Article
- A case of possible anaphylaxis to ASA and structurally unrelated NSAIDs.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2023Article
- Comprehensive chemo-profiling of coumarins enriched extract derived fromSaudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2023Article
- ASPP 092, a phenolic diarylheptanoid fromSaudi journal of biological sciences · 2021Article
- Lipid Formulations and Bioconjugation Strategies for Indomethacin Therapeutic Advances.Molecules (Basel, Switzerland) · 2021Review
- Immunotherapy Resistance in Glioblastoma.Frontiers in genetics · 2021Review
- Efficacy of non-opioid analgesics to control postoperative pain: a network meta-analysis.BMC anesthesiology · 2020Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The launch of the cyclooxygenase-2 (COX-2) selective NSAIDs was based on 2 hypotheses: (1) the major adverse effects limiting the usefulness of nonselective NSAIDs are gastrointestinal in nature and (2) COX-2 selective NSAIDs are associated with fewer gastrointestinal adverse effects than nonselective NSAIDs. At the time of the launch, neither of these hypotheses had been proven and, as documented in this review, both remain uncertain. The increased incidence of total and nongastrointestinal serious adverse events, with the COX-2 selective NSAIDs as compared with nonselective NSAIDs, in the Celecoxib Long-term Arthritis Safety Study (CLASS) and the Vioxx Gastrointestinal Outcomes Research (VIGOR) study remains a major concern. The increased morbidity associated with the COX-2 selective NSAIDs may be a manifestation of the COX-2 selectivity of rofecoxib and celecoxib or the supramaximal doses of these drugs used in the trials. Proof that the increased harm was not caused by the COX-2 selectivity of the drugs depends on demonstration in a randomized controlled trial that COX-2 selective NSAIDs at usual doses are as effective as nonselective NSAIDs and cause fewer gastrointestinal serious adverse events without increasing the incidence of total nongastrointestinal serious adverse events.
Indexed as
Identifiers
12427705PMC134294W2154362045What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.