{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T21:50:06Z","timestamp":1767995406333,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2006,11,6]],"date-time":"2006-11-06T00:00:00Z","timestamp":1162771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>COX\u20102 and NSAIDS differ in their gastrointestinal (GI) and cardiovascular (CV) toxicity from pharmacological, clinical and epidemiologic point of views.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Describe the patterns of use of NSAIDS and COX\u20102 in The Health Improvement Network (THIN) database in UK and the PharMetrics database in USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined the experience of 10 distinct cohorts of new users of diclofenac, naproxen, ibuprofen, piroxicam, other NSAIDS, meloxicam, celecoxib, etoricoxib, rofecoxib and valdecoxib. The study period was 1 January 1995 through 2004 (31 March in UK and 28 February in USA). We collected information on covariates including history of upper GI disease, CV disease, hepatic disease, dosage, concomitant medication, and visits to a rheumatologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 486\u2009076 unique patient\u2010drug pairs in UK and 1\u2009533\u2009239 in USA. In UK population 78\u2009201 (16%) were COX\u20102 users and in PharMetrics 324\u2009206 (21%) were COX\u20102 users. Diclofenac and ibuprofen (NSAIDS), and celecoxib and rofecoxib (COX\u20102) were the agents prescribed most frequently. The duration of therapy was longer among celecoxib and rofecoxib users than among other users. More COX\u20102 users than NSAIDS users received concomitant gastroprotective agents (GPA), corticosteroids and anti\u2010platelet therapy, and had a history of thromboembolic events and hypertension. PharMetrics patients were prescribed higher doses of NSAIDS and COX\u20102. The use of any single agent for more than 90 days was uncommon, but more frequent in PharMetrics. Switching was uncommon and was generally to a NSAID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our results confirm some previous findings from other authors such as the presence of both GI and CV channelling to COX\u20102 agents but refute others, such as the frequency of drug switching between these agents. The typical use of COX\u20102 agents in practice is for shorter duration, and at lower doses, than was employed in randomized clinical trials. This difference may help clarify the apparent discrepancy with respect to CV toxicity between the results from clinical trials, which showed a higher CV risk with these drugs, and non\u2010experimental epidemiologic studies, which showed lower or no increase in risk. Copyright \u00a9 2006 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.1343","type":"journal-article","created":{"date-parts":[[2006,11,6]],"date-time":"2006-11-06T12:37:59Z","timestamp":1162816679000},"page":"861-872","source":"Crossref","is-referenced-by-count":42,"title":["Use of cyclo\u2010oxygenase 2 inhibitors (COX\u20102) and prescription non\u2010steroidal anti\u2010inflammatory drugs (NSAIDS) in UK and USA populations. Implications for COX\u20102 cardiovascular profile"],"prefix":"10.1002","volume":"15","author":[{"given":"F\u00e9lix M.","family":"Arellano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne Ulcickas","family":"Yood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles E","family":"Wentworth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan A","family":"Oliveria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Rivero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anila","family":"Verma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth J","family":"Rothman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,11,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199906173402407"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.14.2093"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-003-0661-8"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021907"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7349.1287"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200109000-00018"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7046.1563"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011233432103"},{"key":"e_1_2_1_10_2","first-page":"171","article-title":"COX\u20102 selective non\u2010steroidal anti\u2010inflammatory drugs and the risk of coronary heart disease","volume":"360","author":"Ray WA","year":"2002","journal-title":"Lancet"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000127578.21885.3E"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17864-7"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050493"},{"key":"e_1_2_1_14_2","unstructured":"Merck Announces Voluntary Worldwide Withdrawal of VIOXX\u00ae.http:\/\/www.vioxx.com\/rofecoxib\/vioxx\/consumer\/index.jsp. 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