Table 3.
Observational studies: adjusted relative risk estimates (95% confidence interval) for cardiovascular ischaemia with selective cyclooxygenase-2 inhibitors
| Citation | Exposure | All celecoxib | All rofecoxib | Rofecoxib ≤ 25 day−1 | Rofecoxib > 25 day−1 |
|---|---|---|---|---|---|
| Singh et al.[5] | Jan. 1999 to June 2004 | 1.09 (1.02, 1.15) | 1.32 (1.22, 1.42) | 1.16 (no CI) | 2.4 (no CI) |
| Sturkenboom et al.[6] | 1999–2004 | NR | 1.52 (1.08, 2.15) | NR | 2.32 (1.2, 4.4)‡ |
| Hippsley-Cox & Coupland [7] | Aug. 2000 to July 2004 | 1.21 (0.96, 1.54) | 1.32 (1.09, 1.61) | NR | NR |
| Johnsen et al.[8] | Jan. 2000 to Dec. 2003 | 1.25 (0.97, 1.62) | 1.80 (1.47, 2.21) | NR | NR |
| Levesque et al.[9] | Jan. 1999 to June 2002 | 0.99 (0.85, 1.16) | 1.24 (1.05, 1.46) | 1.21 (1.02, 1.43) | 1.73 (1.09, 2.76) |
| Kimmel et al.[10] | May 1998 to Dec. 2002 | 0.43 (0.23, 0.79) | 1.16 (0.70, 1.93) | NR | NR |
| Graham et al.[1] | Jan. 1999 to Dec. 2001 | 0.84 (0.67, 1.04) | 1.34 (0.98, 1.82) | 1.23 (0.89, 1.71) | 3.00 (1.09, 8.31) |
| Solomon et al.[11] | Jan. 1999 to Dec. 2000 | 0.93 (0.84, 1.02) | 1.14 (1.00, 1.31) | 1.21 (1.01, 1.44)* | 1.70 (1.07, 2.71)† |
| Mamdani et al.[12] | Apr. 1998 to Mar. 2001 | 0.90 (0.70, 1.2) | 1.0 (0.8, 1.4) | NR | NR |
| Ray et al.[13] | Jan. 1999 to June 2001 | 0.96 (0.76, 1.21) | NR | 1.03 (0.78, 1.35) | 1.70 (0.98, 2.95) |
| Pooled risk estimate | Random effects | 0.99 (0.90, 1.09) | 1.30 (1.18, 1.44) | 1.18 (1.06, 1.32) | 1.85 (1.44, 2.36) |
| Fixed effects | 1.03 (0.98, 1.08) | 1.30 (1.23, 1.37) | 1.18 (1.06, 1.32) | 1.85 (1.44, 2.38) |
The reference exposure category in these calculations was no (or remote) use of any anti-inflammatory drug. The analysis excludes the study of Shaya et al. [14] owing to use of nonselective nonsteroidal anti-inflammatory drugs as the reference exposure category.
CI, 95% confidence interval; NR, not reported.
Celecoxib ≤200 mg day−1 was the reference exposure category.
Celecoxib >200 mg day−1 was the reference exposure category.
Twice the ‘recommended daily dose’. Only Levesque et al. [9] provided data on celecoxib doses: ≤200 mg day−1 adjusted rate ratio 0.98 (0.83, 1.17); > 200 mg day−1 1.00 (0.78, 1.29). Sturkenboom et al. [6] reported rofecoxib was associated with an increased risk of stroke/transient ischaemic attack but not myocardial infarction/sudden cardiac death; only the risk estimate for the former was reported and these are the values in the table.