Gastrointestinal bleeding after the introduction of COX 2 inhibitors: ecological study
This is a very interesting article. When the COX-2 selective inhibitors were first released, I was seeing many patients come in that were prescribed this class of drugs, most inappropriately (was only supposed to be used in patients at high risk of GI complications). However, the number has dropped off to almost zero. This once blockbuster class of drugs seems to be falling to research that is finally showing that it is not all that effective as a pain med, and it’s side effect profile is really nothing to brag about, either. And all this coupled with the fact that this is a very expensive class of drugs compared to other NSAIDs.
This article notes that, with the 41% increase in NSAID use (due entirely to the increased use of COX-2 inhbitors), a 10% increase in hospitalization rates for upper GI bleeds was seen. Sell your Pharmacia stock.
bmj.com Mamdani et al. 328 (7453): 1415 –