Death naproxen

Aspirin (now a generic name) is one of a number of nonsteroidal antiinflammatory drugs (NSAIDs) others include ibuprofen and naproxen (see Fig. 21-15), all now sold over the counter. Unfortunately, aspirin reduces but does not eliminate the side effects of salicylates. In some patients, aspirin itself can produce stomach bleeding, kidney failure, and, in extreme cases, death. New NSAIDs with the beneficial effects of aspirin but without its side effects would be medically valuable. 

Graham etaUi 57] 2005 Nested case- Incidence of control serious coronary heart disease, defined as acute Ml requiring admission or sudden cardiac death 8143 individuals 18-84 years who filled at least one prescription for a Cox-2 selective or non-selective NSAID. 31496 matched by date of the case event, birth year, sex and health plan region Adjusted Odds Ratio Current use Celecoxib 0.84 (0.67-1.04). Ibuprofen 1.06 (0.96-1.17). Naproxen 1.14 (1.00-1.30) Rofecoxib all doses 1.34 (0.98-1.82) Rofecoxib (<25mg/day) 1.23 (0.89-1.71). Rofecoxib (>25mg/day) 3.00 (1.09-8.31) Other NSAIDS 1.13 (1.01-1.27) Increased risk of coronary heart disease with all studied doses of rofecoxib (less than celecoxib). No protection against coronary heart disease with naproxen. 

Patients with osteoarthritis or rheumatoid arthritis are randomized to one of three treatments, celecoxib, ibuprofen, or naproxen, and the primary endpoint is the occurrence of a cardiovascular endpoint a nonfatal myocardial infarction, a nonfatal stroke, or any cardiovascular death. Non-inferiority will be assessed for three different pairwise comparisons celecoxib versus ibuprofen, celecoxib versus naproxen, and ibuprofen versus naproxen. The definition of non-inferiority differs somewhat from the fixed margin approach describe earlier in that there are separate criteria for the confidence interval and the point estimate. The hazard ratio for each comparison will be calculated, and non-inferiority will be concluded if the upper end of the... 

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