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Safety differences in arthritis options

From Chris Walker, Senior scientific adviser cox-2s, Pfizer, Walton Oaks

Further to your report (News, 10 December) of the Hippisley-Cox paper published in the BMJ (3 December), I wish to express my concern that the conclusions of the paper do not accurately reflect the data as presented.

This study found important differences between celecoxib and the studied NSAIDs in terms of the risk of GI adverse effects. Specifically, celecoxib was the only treatment that did not significantly increase the risk of GI adverse events (adjusted RR 1.11, 95 per cent CI 0.86 to 1.41) compared with control patients.

The authors comment that the number of celecoxib-taking patients was low, yet the upper limit of the 95 per cent CI for celecoxib is less than the lower limits for naproxen (1.73), diclofenac (1.78), other NSAIDs (1.43) and aspirin (1.49) ­ supporting the relative GI safety of celecoxib.

We do not believe the conclusion fully acknowledges safety differences that the data showed among various arthritis treatment options. In this study, celecoxib was the treatment with the lowest risk of GI complications.

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