Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: While I concur with Dr Mukherjee
and colleagues1 that further research is
warranted given the increased incidence of CV events associated with rofecoxib,
there are numerous methodological flaws in their analysis.
First, the authors base their conclusion on 4 studies. However, the
odds ratios from these studies shows significant heterogeneity. The heterogeneity
is even greater among the CLASS and VIGOR trials, which is probably a reflection
of different patient demographics, choice of NSAID or COX-2 comparators, or
other differences. Thus, the conclusion about a common "class effect" of COX-2
inhibitors across these studies seems inappropriate.
Singh G. Cardiovascular Events and COX-2 Inhibitors. JAMA. 2001;286(22):2808-2813. doi:10.1001/jama.286.22.2808