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Fewer GP side-effects with cox-2s than NSAID/PPI

By Lilian Anekwe

Patients with arthritis given an NSAID plus a PPI are more than four times more likely to suffer upper or lower gastrointestinal adverse clinical outcomes than those who receive a cox-2 inhibitor instead.

The CONDOR study, by researchers from the US and Hong Kong, randomised nearly 5,000 patients to celecoxib 200mg twice a day or diclofenac 75mg twice a day plus omeprazole 20mg once daily.

Those receiving diclofenac plus omeprazole were more than four times more likely to suffer GI problems and 114 (6%) patients taking celecoxib versus 167 (8%) taking diclofenac plus omeprazole withdrew early because of gastrointestinal adverse events.

Study leader Professor Francis Chan, associate professor in gastroenterology at the Prince of Wales hospital in Hong Kong concluded: ‘CONDOR has provided new data relevant to patients requiring anti-inflammatory therapy who are at increased gastrointestinal but not increased cardiovascular risk.

‘In this population, the gastrointestinal outcomes of a cox-2 selective NSAID were quite different to those of a non-selective NSAID plus a PPI. The findings of the CONDOR trial should encourage guideline committees to review their treatment recommendations for arthritis patients.'

The Lancet, published online 17 June 2010