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July 2, 2003

Pain Management in Patients With Osteoarthritis—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(1):36. doi:10.1001/jama.290.1.36-a

To the Editor: In his Clinical Crossroads article about a 57-year-old man with arthritis, Dr Lonner1 stated that cyclooxygenase-2 (COX-2) selective inhibitors are as effective as nonselective nonsteroidal anti-inflammatory drugs (NSAIDs), but may have "decreased toxicity on non-target tissues such as the gastric mucosa, although at 15 to 20 times the cost." In support of this assertion he cites data from the Celecoxib Long-term Arthritis Safety Study (CLASS).2 In fact, however, a later analysis revealed that 12 months of celecoxib was no safer than other NSAIDs, and the US Food and Drug Administration disagreed with the manufacturer's claim that celecoxib was safer.3

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