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Meloxicam linked to higher risk of adverse cardiovascular events than Celecoxib and Rofecoxib


Researchers at the National Yang-Ming University, Taipei, ( Taiwan ) assessed the risk of acute myocardial infarction, angina, stroke and transient ischaemic attack ( TIA ) in long-term users of Rofecoxib ( Vioxx ) and Celecoxib ( Celebrex ), and compared this data with that for those using Meloxicam ( Mobic ).

Patients included in the study had used Celecoxib, Rofecoxib or Meloxicam for at least 180 days.
Data were taken from National Health Insurance database for the period from 2001 to 2003.

In patients without a history of a cardiovascular event within the year before drug treatment began, the overall rates of myocardial infarction, angina, stroke and TIA were 1.1%, 0.6%, 2.0% and 0.6%, respectively.

In those with cardiovascular events in the year before treatment began, the overall rates of myocardial infarction, angina, stroke and TIA were 5.0%, 4.8%, 6.6% and 5.8%, respectively.

Compared with Meloxicam users, Celecoxib users had lower hazard ratios ( HRs ) for the development of myocardial infarction ( HR 0.78 ) and stroke ( HR 0.81 ).
Rofecoxib users were at no higher risk of cardiovascular events than those receiving Meloxicam.

Regardless of treatment, having had a cardiovascular event in the year before treatment began played a significant role in the development of the same cardiovascular event during the prescription period; the hazard ratios associated with having had the same cardiovascular event in the past year, versus not having had such an event, were 3.02 for myocardial infarction, 5.82 for angina, 2.44 for stroke and 7.16 for TIA.

According to authors, patients taking Celecoxib had a lower risk of cardiovascular events than those taking Meloxicam. Patients taking Rofecoxib were not found to be at higher cardiovascular risk than those taking Meloxicam.
The most significant determinant of cardiovascular risk was a history of such cardiovascular disease in the year preceding treatment initiation.
Patients with a history of other medical conditions also appeared to be at higher risk of adverse cardiovascular events.

Source: Drug Safety, 2006


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