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Risk of hospitalization for angio-oedema among users of newer COX-2 selective inhibitors and other nonsteroidal anti-inflammatory drugs.

Downing A, Jacobsen J, Sorensen HT, McLaughlin JK, Johnsen SP

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. a.downing@leeds.ac.uk

AIM: To examine the risk of angio-oedema among users of the newer cyclooxygenase (COX)-2 selective inhibitors celecoxib and rofecoxib and other non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) in a population-based case-control study. METHODS: Cases of angio-oedema were identified from hospital discharge registries from three Danish counties between 1 January 2000 and 31 December 2003 (n = 377) and 10 matched population controls per case were selected from the Civil Registration System (n = 3747). Data on newer COX-2 selective inhibitor and other NSAID use (current and former) were obtained from prescription databases. Data on potential confounding factors were also collected. Conditional logistic regression was used to compute relative risks for angio-oedema according to drug exposure. RESULTS: The crude relative risks for the newer COX-2 selective inhibitors were higher than those for other NSAIDs. After adjustment for confounding, the relative risk for current use of newer COX-2 selective inhibitors was 0.96 [95% confidence interval (CI) 0.46, 2.03], whereas the risk for other NSAIDs was 1.77 (95% CI 1.23, 2.58). CONCLUSION: Our data support the hypothesis that newer COX-2 selective inhibitors are safe in relation to angio-oedema. However, given other current health concerns related to these drugs, their use should continue to be carefully monitored.

Published 25 September 2006 in Br J Clin Pharmacol, 62(4): 496-501.
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