PMID- 26448006
OWN - NLM
STAT- MEDLINE
DCOM- 20160119
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 94
IP  - 40
DP  - 2015 Oct
TI  - Network Meta-Analysis Comparing Relatively Selective COX-2 Inhibitors Versus 
      Coxibs for the Prevention of NSAID-Induced Gastrointestinal Injury.
PG  - e1592
LID - 10.1097/MD.0000000000001592 [doi]
LID - e1592
AB  - Currently 2 difference classes of cyclooxygenase (COX)-2 inhibitors, coxibs and 
      relatively selective COX-2 inhibitors, are available for patients requiring 
      nonsteroidal anti-inflammatory drug (NSAID) therapy; their gastroprotective 
      effect is hardly directly compared. The aim of this study was to compare the 
      gastroprotective effect of relatively selective COX-2 inhibitors with coxibs. 
      MEDLINE, EMBASE, and the Cochrane Library (from their inception to March 2015) 
      were searched for potential eligible studies. We included randomized controlled 
      trials comparing coxibs (celecoxib, etoricoxib, parecoxib, and lumiracoxib), 
      relatively selective COX-2 inhibitors (nabumetone, meloxicam, and etodolac), and 
      nonselective NSAIDs with a study duration >/= 4 weeks. Comparative effectiveness 
      and safety data were pooled by Bayesian network meta-analysis. The primary 
      outcomes were ulcer complications and symptomatic ulcer. Summary effect-size was 
      calculated as risk ratio (RR), together with the 95% confidence interval (CI). 
      This study included 36 trials with a total of 112,351 participants. Network 
      meta-analyses indicated no significant difference between relatively selective 
      COX-2 inhibitors and coxibs regarding ulcer complications (RR, 1.38; 95% CI, 
      0.47-3.27), symptomatic ulcer (RR, 1.02; 95% CI, 0.09-3.92), and endoscopic ulcer 
      (RR, 1.18; 95% CI, 0.37-2.96). Network meta-analyses adjusting potential 
      influential factors (age, sex, previous ulcer disease, and follow-up time), and 
      sensitivity analyses did not reveal any major change to the main results. Network 
      meta-analyses suggested that relatively selective COX-2 inhibitors and coxibs 
      were associated with comparable incidences of total adverse events (AEs) (RR, 
      1.09; 95% CI, 0.93-1.31), gastrointestinal AEs (RR, 1.04; 95% CI, 0.87-1.25), 
      total withdrawals (RR, 1.00; 95% CI, 0.74-1.33), and gastrointestinal AE-related 
      withdrawals (RR, 1.02; 95% CI, 0.57-1.74). Relatively selective COX-2 inhibitors 
      appear to be associated with similar gastroprotective effect and tolerability as 
      coxibs. Owing to the indirectness of the comparisons, future research is required 
      to confirm the study conclusion.
FAU - Yang, Man
AU  - Yang M
AD  - From the Department of Gastroenterology, Songgang People's Hospital, Shenzhen, 
      Guangdong, China (MY, J-QO, MZ, J-HH, P-GL); Department of Gastroenterology, 
      Peking University Shenzhen Hospital, Shenzhen, Guangdong, China (MY, BZ); 
      Department of Burns and Cutaneous Surgery, Xijing Hospital, Fourth Military 
      Medical University, Xi'an, China (H-TW); and Special Minimally Invasive Surgery, 
      The First Hospital of Lanzhou University, Hepatopancreatobiliary Surgery 
      Institute of Gansu, Cancer Center of Clinical Medical College, Lanzhou 
      University, Lanzhou, Gansu Province, China (W-BM).
FAU - Wang, Hong-Tao
AU  - Wang HT
FAU - Zhao, Miao
AU  - Zhao M
FAU - Meng, Wen-Bo
AU  - Meng WB
FAU - Ou, Jin-Qing
AU  - Ou JQ
FAU - He, Jun-Hui
AU  - He JH
FAU - Zou, Bing
AU  - Zou B
FAU - Lei, Ping-Guang
AU  - Lei PG
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Cyclooxygenase 2 Inhibitors)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Cyclooxygenase 2 Inhibitors/*pharmacology
MH  - Drug Tolerance
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Stomach/*drug effects
MH  - Stomach Ulcer/chemically induced/diagnosis
PMC - PMC4616749
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2015/10/09 06:00
MHDA- 2016/01/20 06:00
PMCR- 2015/10/09
CRDT- 2015/10/09 06:00
PHST- 2015/10/09 06:00 [entrez]
PHST- 2015/10/09 06:00 [pubmed]
PHST- 2016/01/20 06:00 [medline]
PHST- 2015/10/09 00:00 [pmc-release]
AID - 00005792-201510010-00016 [pii]
AID - 10.1097/MD.0000000000001592 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2015 Oct;94(40):e1592. doi: 10.1097/MD.0000000000001592.