{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:30:19Z","timestamp":1761561019546},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,12,13]],"date-time":"2005-12-13T00:00:00Z","timestamp":1134432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2006,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Selective cyclooxygenase\u20102 inhibitors have been marketed as alternatives of conventional, non\u2010steroidal anti\u2010inflammatory drugs with the purpose of reducing\/eliminating the risk of ulcer complications. Unexpectedly, randomized\u2010controlled trials revealed that long\u2010term use of coxibs, such as rofecoxib, significantly increased the risk of myocardial infarction and stroke, while the use of valdecoxib was associated with potentially life\u2010threatening skin reactions.<\/jats:p><jats:p>Subsequently, rofecoxib and valdecoxib were withdrawn from the market. Although more strict precautions for other coxibs, such as celecoxib, etoricoxib, lumiracoxib and parecoxib, may be accepted\/recommended by regulatory agencies, a critical review of published data suggests that their use may not be justified \u2013 even in high\u2010risk patients \u2013 taking benefits, costs and risks into consideration. Clinicians should, therefore, never prescribe coxibs to patients with cardiovascular risk factors, and should only reluctantly prescribe coxibs to patients with a history of ulcer disease or dyspepsia to overcome persistent pain due to, e.g. rheumatoid arthritis or osteoarthritis.<\/jats:p><jats:p>Instead, they should consider using conventional non\u2010steroidal anti\u2010inflammatory drugs in combination with a proton pump inhibitor or a prostaglandin analogue, especially for patients with increased cardiovascular risks, i.e. established ischaemic heart disease, cerebrovascular disease and\/or peripheral arterial disease, or alternatively acetaminophen. An evidence\u2010based algorithm for treatment of a chronic arthritis patient with one or more gastrointestinal risk factors is presented.<\/jats:p>","DOI":"10.1111\/j.1365-2036.2006.02745.x","type":"journal-article","created":{"date-parts":[[2005,12,13]],"date-time":"2005-12-13T14:11:14Z","timestamp":1134483074000},"page":"27-33","source":"Crossref","is-referenced-by-count":24,"title":["Systematic review: coxibs, non\u2010steroidal anti\u2010inflammatory drugs or no cyclooxygenase inhibitors in gastroenterological high\u2010risk patients?"],"prefix":"10.1111","volume":"23","author":[{"given":"O. 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