Evidence map›Paper›PMID 17412741›Full record

Trial reportAnnals of the rheumatic diseases2007

Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib.

M E Farkouh, J D Greenberg, R V Jeger, K Ramanathan, F W A Verheugt, J H Chesebro, H Kirshner, J S Hochman, C L Lay, S Ruland and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Annals of the rheumatic diseases, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
12.0field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it, 122 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Article
  13. Clinical Pharmacology and Cardiovascular Safety of Naproxen.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2017
    Review
  14. EVALUATION OF THE ANTI-INFLAMMATORY CAPACITY OF BETA-SITOSTEROL IN RODENT ASSAYS.African journal of traditional, complementary, and alternative medicines : AJTCAM · 2017
    Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Anti-inflammatory and chondroprotective effects of atorvastatin in a cartilage explant model of osteoarthritis.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2015
    Article
  20. NSAIDs and Cardiovascular Diseases: Role of Reactive Oxygen Species.Oxidative medicine and cellular longevity · 2015
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 3 countries.

M E FarkouhMount Sinai Cardiovascular Institute, Mount Sinai School of Medicine, One Gustave L Levy Place, Box 1074, New York, NY 10029, USA. michael.farkouh@mssm.edu
J D Greenberg
R V Jeger
K Ramanathan
F W A Verheugt
J H Chesebro
H Kirshner
J S Hochman
C L Lay
S Ruland
B Mellein
P T Matchaba
V Fuster
S B Abramson
New York University · USCardiovascular Institute of the South · USNew York University Langone Orthopedic Hospital · USJacksonville College · USNovartis (Switzerland) · CHRadboud University Nijmegen · NLSt. Luke's-Roosevelt Hospital Center · USUniversity of Illinois Chicago · USVanderbilt University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvidence suggests that both selective cyclooxygenase (COX)-2 inhibitors and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of cardiovascular events. However, evidence from prospective studies of currently available COX-2 inhibitors and non-selective NSAIDs is lacking in patients at high cardiovascular risk who are taking aspirin.

objectiveTo determine the cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib.

methodsThe Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET) of 18 325 patients with osteoarthritis comprised two parallel substudies, comparing lumiracoxib (COX-2 inhibitor) with either ibuprofen or naproxen. A post hoc analysis by baseline cardiovascular risk, treatment assignment, and low-dose aspirin use was performed. The primary composite end point was cardiovascular mortality, non-fatal myocardial infarction, and stroke at 1 year; a secondary end point was the development of congestive heart failure (CHF).

resultsIn high risk patients among aspirin users, patients in the ibuprofen substudy had more primary events with ibuprofen than lumiracoxib (2.14% vs 0.25%, p = 0.038), whereas in the naproxen substudy rates were similar for naproxen and lumiracoxib (1.58% vs 1.48%, p = 0.899). High risk patients not taking aspirin had fewer primary events with naproxen than with lumiracoxib (0% vs 1.57%, p = 0.027), but not for ibuprofen versus lumiracoxib (0.92% vs 0.80%, p = 0.920). Overall, CHF developed more often with ibuprofen than lumiracoxib (1.28% vs 0.14%; p = 0.031), whereas no difference existed between naproxen and lumiracoxib.

conclusionsThese data suggest that ibuprofen may confer an increased risk of thrombotic and CHF events relative to lumiracoxib among aspirin users at high cardiovascular risk. The study indicates that naproxen may be associated with lower risk relative to lumiracoxib among non-aspirin users. This study is subject to inherent limitations, and therefore should be interpreted as a hypothesis-generating study.

Indexed as

AgedAnti-Inflammatory Agents, Non-SteroidalAspirinCardiovascular DiseasesCyclooxygenase 2 InhibitorsDiclofenacDouble-Blind MethodDrug Therapy, CombinationFemaleHeart Defects, CongenitalHumansIbuprofenMaleMiddle AgedNaproxenOsteoarthritisAnti-Inflammatory Agents, Non-SteroidalAspirinCyclooxygenase 2 InhibitorsDiclofenacIbuprofenlumiracoxibNaproxen

Identifiers

PMID17412741
PMCPMC1954641
OpenAlexW2115903771

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.