GPs warned over switching to Cox-2

Professor Martin Underwood says GPs should think carefully before switching over-65s with arthritis from standard-dose ibuprofen to Cox-2 inhibitors after his study showed it may not reduce gastrointestinal bleed rates.

Professor Underwood, professor of general practice at St Bartholomew's and the London, Queen Mary, University of London, found all published studies comparing Cox-2s with NSAIDs used an ibuprofen dose of 2-4g/day ­ double the dose prescribed by most GPs.

He told the British Society for Rheumatology conference this month that using lower doses of ibuprofen reduced GI bleed rates by 62 per cent, compared with a 67 per cent reduction in patients switched to a Cox-2.