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. 2019 May 9;36(Suppl 1):25–44. doi: 10.1007/s40266-019-00664-x

Table 2.

Summary of significant safety findings for COX-2 inhibitors versus placebo in patients with osteoarthritis

Outcomes No. of participants
Follow-up
Certainty of the evidence (GRADE) Relative effect (95% CI) Risk ratio Anticipated absolute effects
Risk with placebo Risk difference with COX-2 inhibitors
Treatment-related adverse events 7463 ⊕⊕⊕⊕
HIGH
1.26 (1.09–1.46) 144 per 1000 37 more per 1000 (13 more to 66 more)
Upper gastrointestinal adverse events overall 23,974 ⊕⊕⊕⊕
HIGH
1.19 (1.03–1.38) 29 per 1000 5 more per 1000 (1 more to 11 more)
Abdominal pain 9907 ⊕⊕⊕⊕
HIGH
1.40 (1.08–1.80) 23 per 1000 9 more per 1000 (2 more to 19 more)
Hypertension 7360 ⊕⊕⊕⊕
HIGH
1.45 (1.01–2.10) 27 per 1000 12 more per 1000 (0 fewer to 30 more)
Heart failure and edema 14,111 ⊕⊕⊕⊕
HIGH
1.68 (1.22–2.31) 10 per 1000 7 more per 1000 (2 more to 14 more)

GRADE Working Group grades of evidence: High certainty we are very confident that the true effect lies close to that of the estimate of the effect; Moderate certainty we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different; Low certainty our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect; Very low certainty we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect

The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)

CI confidence interval, COX-2 cyclooxygenase-2