What is already known about this subject• There is some evidence that the risk of cutaneous reactions is lower in patients taking newer cyclooxygenase (COX)-2 selective inhibitors than in users of other nonsteroidal antiinflammatory drugs (NSAIDs).• However, the data are inconclusive and formal epidemiological evidence is lacking.
What this study adds• This population-based case-control study found no elevated risk for angio-oedema amongst users of newer COX-2 selective inhibitors, whilst users of other NSAIDS were shown to have an increased risk.• 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.
AimTo 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.
MethodsCases 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 Reg istration 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.
ResultsThe 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).
ConclusionOur 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.
Angioedema risk in users of newer COX-2 selective inhibitors and other NSAIDsBr J Clin Pharmacol 62 :4 497
