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December 12, 2001

Cardiovascular Events and COX-2 Inhibitors

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(22):2808-2813. doi:10.1001/jama.286.22.2808

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.

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