The combination of proton pump inhibitors and COX-2 inhibitors is the most effective approach, Targownik told Reuters Health. "Celecoxib seems especially protective, and given the relatively weak evidence (compared with other COX-2 inhibitors) of its being associated with cardiovascular complications, its use should be more strongly considered."
In an accompanying editorial, Dr. David Y. Graham of the Baylor College of Medicine, Houston, and Dr. Francis K.L. Chan of the Chinese University of Hong Kong emphasize the importance of assessing a patient's risk of gastrointestinal and other complications. They noted, for example, that the Canadian results "are consistent with the notion that no form of NSAID therapy should be used in patients with high gastrointestinal and high cardiovascular risk."
SOURCE: Gastroenterology, April 2008.
