COX-2 inhibitors are as effective as non-selective NSAIDs and are well tolerated. Naproxen reduces prostaglandin synthesis in the gastric mucosa by 70% whereas rofecoxib has no effect. Endoscopic studies have shown that rofecoxib is associated with significantly less risk of upper gastrointestinal complications than are the non-selective drugs in patients with osteoarthritis. Similar findings have been reported in patients with rheumatoid arthritis. Now a large international study has produced similar results.

At 48 …