Figure 5.
Predicted annual absolute risks of major vascular events or upper gastrointestinal complications with long-term, high-dose therapy.
Notes: Risks (±1 standard error) are shown for (A) coxib, (B) diclofenac, (C) ibuprofen, and (D) naproxen for patients with the specified predicted annual risk of a major vascular event (left panels) or an upper gastrointestinal complication (right panels). The predicted annual risk of upper gastrointestinal complications is lower for NSAIDs with greater COX-2 selectivity (eg, coxibs and diclofenac), while the risk of major vascular events is comparable between these drugs. Naproxen, which has no COX-2–specific selectivity, shows some cardioprotective effects but more gastrointestinal toxicity. Reproduced from Coxib and traditional NSAID Trialists’ (CNT) Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382(9894):769–779. Permission conveyed through Copyright Clearance Center, Inc.20
Abbreviations: COX, cyclooxygenase; NSAIDs, non-steroidal anti-inflammatory drug; pa, per annum; SE, standard error.