Clinic 7 - Eicosanoids A Brief Clinical Correlate May 6,...

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A Brief Clinical Correlate Eicosanoids May 6, 2009
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Clinical Correlate: COX-2 Inhibitors Lancet, 365:472-781 (2005) Lancet, 449-451 (2005) 1 3 2 * May 6, 2009
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Celecoxib and Rofecoxib (Vioxx) were approved by FDA in 1999 In 2000, the results of a large randomized controlled trial were published: Vioxx Gastrointestinal Outcomes Research (VIGOR): Two groups of patients with rheumatoid arthritis were compared: Vioxx (50 mg/day) vs. naproxen (a nonspecific COX inhibitor, e.g. Aleve) (Note: no placebo) Since there was no placebo, the effect of Vioxx on incidence of myocardial infarction could have been due to one of three possibilities: 1. An adverse effect of rofecoxib in particular 2. An adverse effect of coxibs in general 3. Protective effect of naproxen Good news: 50% decrease in clinically relevant upper GI events Bad News: 5x increase in incidence of acute myocardial infarction more studies An Initial Study
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Other studies with other coxibs gave mixed results; in 2002, FDA required label
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This note was uploaded on 06/08/2009 for the course BCH 120 taught by Professor Luben,norman,henry during the Spring '09 term at UC Riverside.

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Clinic 7 - Eicosanoids A Brief Clinical Correlate May 6,...

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