Study of patients on COX-2 inhibitors does not show increased cardiovascular risk

An observational study of 6,250 patients enrolled in the Maryland Medicaid program found that COX-2 inhibitors did not increase the risk for cardiovascular events over nonnaproxen NSAIDs in a high-risk population.

Fadia T. Shaya, Ph.D., M.P.H., from University of Maryland, Baltimore, and colleagues analyzed the claims of noninstituionalized Medicaid enrollees who received at least a 60-day supply of a COX-2 inhibitor or other prescription NSAID between June 2000 and June 2002. Naproxen users were excluded. Of the 6,250 patients, 1,005 used a COX-2 inhibitor and 5,245 used some other NSAID. The patients in the study were 70 percent female, 50 percent African American, and 30 percent were older than 50 years. “Overall, 12 percent of the patients had at least one cardiovascular thrombotic [blood clotting] event after treatment within the follow-up period,” the researchers report.

The authors conclude: “The results of this analysis do not show a difference in the rate of cardiovascular events between COX-2 inhibitors and nonnaproxen NSAIDs. Given that the study population had higher baseline cardiovascular risk, these observations provide more confidence that the widespread use of COX-2 inhibitors will not be associated with an increase in thrombotic or coronary artery events. This is particularly important because NSAIDs are often used in older, higher-risk patients.”