Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002
Several articles in the May 27 issue of the ARCHIVES helped to clarify some of the clinical issues regarding the risk of cardiovascular events in patients treated with COX-2 inhibitors. The editorial by Dalen1 noted that many users of NSAIDs and COX-2 inhibitors are in the age group that has or is at risk of having coronary artery disease and suggested that "the concomitant use of low-dose aspirin (80 mg/d) should be strongly considered in patients with a history of coronary artery disease, stroke, transient ischemic attack, or peripheral vascular disease." In our respectful opinion, the concomitant use of aspirin and COX-2 inhibitors may not represent the most cost-effective approach to patient treatment. The addition of aspirin to a COX-2 inhibitor regimen changes the balance of incremental costs and benefits of COX-2 inhibitors over standard NSAID therapy.
Pickard AS, Schumock GT. Aspirin Use May Change Cost-effectiveness of COX-2 Inhibitors. Arch Intern Med. 2002;162(22):2637. doi: