Are All Oral COX-2 Selective Inhibitors the Same? A Consideration of Celecoxib, Etoricoxib, and Diclofenac

Table 4

CV safety of celecoxib, etoricoxib, and diclofenac in patients with OA and RA.

	Meta-analyses
Endpoints	Reference	Comparator	Celecoxib	Diclofenac	Etoricoxib
APTC composite outcome, rate ratio (95% CI)	Trelle et al, 2011 [54]	Placebo	1.43 (0.94–2.16)	1.60 (0.85–2.99)	1.53 (0.74–3.17)
APTC-like composite outcome, RR (95% CI)	Bhala et al, 2013 [11]	Diclofenac	0.94 (0.54–1.63)		1.01 (0.87–1.18)
	Randomized controlled trials
Endpoints	Reference	Celecoxib	Diclofenac		Etoricoxib
Thrombotic events, rate (95% Cl)	Cannon et al, 2006 [57]		1.30 (1.17–1.45)		1.24 (1.11–1.38)
APTC events, rate (95% Cl)	Cannon et al, 2006 [57]		0.87 (0.76–1.00)		0.84 (0.73–0.95)
Serious CV thromboembolic events, %	White et al, 2002 [59]	1.3	1.4

Myocardial infarction, stroke, and vascular death.
Nonfatal myocardial infarction, nonfatal stroke, and vascular death.
Per 100 patient-years at risk, per-protocol comparison.
Myocardial infarction, stroke, and vascular death.
Including cardiac, cerebrovascular, and peripheral vascular events.
p < 0.0033.
OA, osteoarthritis; RA, rheumatoid arthritis; APTC, Antiplatelet Trialists’ Collaboration; RR, relative ratio; RRR, pooled ratio of relative risks; CV, cardiovascular.