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COX-1–Sparing NSAIDs: What Do Small Lesions Mean?


When patients’ GI tracts are viewed with endoscopes, the new COX-2 inhibitors are found to produce one-tenth as many small (3 mm) lesions as do older NSAIDs. But both old and new drugs produce clinical symptoms in similar numbers of patients, so the use of more expensive COX-2 inhibitors is focusing preferentially on those at high risk of GI problems.


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Simon LS et al. Anti-inflammatory and upper gastrointestinal effects of celecoxib in rheumatoid arthritis. JAMA. 1999;282:1921–6.

Peterson WL, Cryer B. COX-1–sparing NSAIDs—is the enthusiasm justified [editorial]? JAMA. 1999;282:1961–3.