Safety of using etoricoxib in cardiac patients taking direct oral anticoagulants and beyond Case report
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Published:
Dec 31, 2024
Keywords:
etoricoxib, nonsteroidal anti-inflammatory drugs, cardiovascular risk, gastrointestinal risk
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Abstract
Nonsteroidal anti-inflammatory drugs are a widely used group of medications with analgesic, anti-inflammatory, and antipyretic effects. However, their use is associated with the risk of adverse effects, particularly concerning the cardiovascular system and the gastrointestinal tract. Etoricoxib, a selective COX-2 inhibitor, is effective in pain relief and has a favorable safety profile, especially in reducing the risk of gastrointestinal bleeding. Clinical studies confirm that etoricoxib is comparable to other nonsteroidal anti-inflammatory drugs in terms of cardiovascular risk while surpassing them in tolerability and lower risk of gastrointestinal complications. Its action profile makes it a suitable choice for treating patients requiring chronic nonsteroidal anti-inflammatory drugs use, particularly those at increased gastrointestinal risk.
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How to Cite
Skwarek, A., & Ozierański, K. (2024). Safety of using etoricoxib in cardiac patients taking direct oral anticoagulants and beyond. Medycyna Faktow (J EBM), 17(4(65), 556-560. https://doi.org/10.24292/01.MF.0424.19
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References
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13. Farkouh ME, Kirshner H, Harrington RA et al.; TARGET Study Group. Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial. Lancet. 2004; 364(9435): 675-84.
14. Chan FK, Lanas A, Scheiman J et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet. 2010; 376(9736): 173-9.
15. Cryer B, Li C, Simon LS et al. GI-REASONS: a novel 6-month, prospective, randomized, open-label, blinded endpoint (PROBE) trial. Am J Gastroenterol. 2013; 108(3): 392-400.
16. Combe B, Swergold G, McLay J et al. Cardiovascular safety and gastrointestinal tolerability of etoricoxib vs diclofenac in a randomized controlled clinical trial (The MEDAL study). Rheumatology (Oxford). 2009; 48(4): 425-32.
17. Laine L, Curtis SP, Cryer B et al.; MEDAL Steering Committee. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet. 2007; 369(9560): 465-73.
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2. Lanas A. A review of the gastrointestinal safety data – a gastroenterologist’s perspective. Rheumatology. 2010; 49(suppl. 2): ii3-10.
3. Medsafe New Zealand Medicines and Medical Devices Safety Authority. NSAIDs and cardiovascular risk.
4. Byrne RA, Rossello X, Coughlan JJ et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023; 44(38): 3720-826.
5. Graham DJ, Campen D, Hui R et al. Risk of acute myocardial infarction and sudden cardiac death in patients treated with cyclo-oxygenase 2 selective and non-selective non-steroidal anti-inflammatory drugs: nested case-control study. Lancet. 2005; 365(9458): 475-81.
6. White WB, West CR, Borer JS et al. Risk of cardiovascular events in patients receiving celecoxib: a meta-analysis of randomized clinical trials. Am J Cardiol. 2007; 99(1): 91-8.
7. Caldwell B, Aldington S, Weatherall M et al. Risk of cardiovascular events and celecoxib: a systematic review and meta-analysis. J R Soc Med. 2006; 99(3): 132-40.
8. Kearney PM, Baigent C, Godwin J et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006; 332(7553): 1302-8.
9. Cannon CP, Curtis SP, FitzGerald GA et al.; MEDAL Steering Committee. Cardiovascular outcomes with etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet. 2006; 368(9549): 1771-81.
10. White WB, Faich G, Whelton A et al. Comparison of thromboembolic events in patients treated with celecoxib, a cyclooxygenase-2 specific inhibitor, versus ibuprofen or diclofenac. Am J Cardiol. 2002; 89(4): 425-30.
11. Bombardier C, Laine L, Reicin A et al.; VIGOR Study Group. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med. 2000; 343(21): 1520-8, 2 p following 1528.
12. Kurth T, Glynn RJ, Walker AM et al. Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal antiinflammatory drugs. Circulation. 2003; 108(10): 1191-5.
13. Farkouh ME, Kirshner H, Harrington RA et al.; TARGET Study Group. Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial. Lancet. 2004; 364(9435): 675-84.
14. Chan FK, Lanas A, Scheiman J et al. Celecoxib versus omeprazole and diclofenac in patients with osteoarthritis and rheumatoid arthritis (CONDOR): a randomised trial. Lancet. 2010; 376(9736): 173-9.
15. Cryer B, Li C, Simon LS et al. GI-REASONS: a novel 6-month, prospective, randomized, open-label, blinded endpoint (PROBE) trial. Am J Gastroenterol. 2013; 108(3): 392-400.
16. Combe B, Swergold G, McLay J et al. Cardiovascular safety and gastrointestinal tolerability of etoricoxib vs diclofenac in a randomized controlled clinical trial (The MEDAL study). Rheumatology (Oxford). 2009; 48(4): 425-32.
17. Laine L, Curtis SP, Cryer B et al.; MEDAL Steering Committee. Assessment of upper gastrointestinal safety of etoricoxib and diclofenac in patients with osteoarthritis and rheumatoid arthritis in the Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) programme: a randomised comparison. Lancet. 2007; 369(9560): 465-73.
18. European Medicines Agency. Question and answers on the review of etoricoxib – containing medicines. Doc. Ref. EMEA/329177/2008.
19. Song GG, Seo YH, Kim JH et al. Relative efficacy and tolerability of etoricoxib, celecoxib, and naproxen in the treatment of osteoarthritis: A Bayesian network meta-analysis of randomized controlled trials based on patient withdrawal. Z Rheumatol. 2016; 75(5): 508-16.