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COX-2 Selective NSAIDSs and risk of hip or knee replacements: A population-based case-control study

COX-2 Selective NSAIDSs and risk of hip or knee replacements: A population-based case-control study
COX-2 Selective NSAIDSs and risk of hip or knee replacements: A population-based case-control study
Disease models of osteoarthritis (OA) have shown that COX-2-selective nonsteroidal anti-inflammatory drugs (NSAIDs, coxibs) may have beneficial effects on cartilage. Clinical or epidemiological evidence for this potential association is scarce. The objective of this study was to evaluate the risk of hip or knee replacement in users of coxibs compared to nonselective NSAIDs. A population-based case-control study was conducted with the Dutch PHARMO Record Linkage System. Cases (n = 26,202) had a first replacement of the hip or knee after enrollment (2000-2009). Up to two controls (without hip or knee replacement) were matched by year of birth, gender, healthcare region, and calendar year. Using conditional logistic regression analysis, odds ratios (ORs) for hip or knee replacement were estimated by comparing long-term (?1 year) nonselective NSAID use with long-term coxib use. Analyses were statistically adjusted for disease and drug history. Long-term use of nonselective NSAIDs was not associated with a different risk of hip replacement (adjusted OR = 0.89, 95 % CI 0.65-1.22) or knee replacement (adjusted OR = 0.74, 95 % CI 0.49-1.11) as compared to long-term coxib use. Results were not different after stratification by gender, age, and cardiovascular or gastrointestinal disease. This study shows that long-term users of nonselective NSAIDs do not have a different risk of hip or knee replacement as compared to long-term coxib users. Therefore, our results do not support that patients with OA could benefit from using coxibs in order to slow progression of this disease.

0171-967X
387-394
Klop, C.
fcfb681b-fb0a-4d48-9b66-35a0a3edfb66
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
Lalmohamed, A.
b3bef1c3-1d0f-4e3d-b999-a00b16aff528
Mastbergen, S.C.
e0718779-34ac-4dec-b43e-5c7ef667231d
Leufkens, H.G.
6f387677-0ec5-408b-bdbc-7a50d49631b6
Noort-van-der-Laan, W.H.
73d651d7-03fc-4710-aec7-2b88538143b3
Bijlsma, J.W.
7cb4fea9-4b22-4ba9-8bfc-01eef45503ef
Welsing, P.M.
3f264c6d-3e5f-4a46-b468-6f36120fe7d0
Klop, C.
fcfb681b-fb0a-4d48-9b66-35a0a3edfb66
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
Lalmohamed, A.
b3bef1c3-1d0f-4e3d-b999-a00b16aff528
Mastbergen, S.C.
e0718779-34ac-4dec-b43e-5c7ef667231d
Leufkens, H.G.
6f387677-0ec5-408b-bdbc-7a50d49631b6
Noort-van-der-Laan, W.H.
73d651d7-03fc-4710-aec7-2b88538143b3
Bijlsma, J.W.
7cb4fea9-4b22-4ba9-8bfc-01eef45503ef
Welsing, P.M.
3f264c6d-3e5f-4a46-b468-6f36120fe7d0

Klop, C., de Vries, Frank, Lalmohamed, A., Mastbergen, S.C., Leufkens, H.G., Noort-van-der-Laan, W.H., Bijlsma, J.W. and Welsing, P.M. (2012) COX-2 Selective NSAIDSs and risk of hip or knee replacements: A population-based case-control study. Calcified Tissue International, 91 (6), 387-394. (doi:10.1007/s00223-012-9646-x). (PMID:23052224)

Record type: Article

Abstract

Disease models of osteoarthritis (OA) have shown that COX-2-selective nonsteroidal anti-inflammatory drugs (NSAIDs, coxibs) may have beneficial effects on cartilage. Clinical or epidemiological evidence for this potential association is scarce. The objective of this study was to evaluate the risk of hip or knee replacement in users of coxibs compared to nonselective NSAIDs. A population-based case-control study was conducted with the Dutch PHARMO Record Linkage System. Cases (n = 26,202) had a first replacement of the hip or knee after enrollment (2000-2009). Up to two controls (without hip or knee replacement) were matched by year of birth, gender, healthcare region, and calendar year. Using conditional logistic regression analysis, odds ratios (ORs) for hip or knee replacement were estimated by comparing long-term (?1 year) nonselective NSAID use with long-term coxib use. Analyses were statistically adjusted for disease and drug history. Long-term use of nonselective NSAIDs was not associated with a different risk of hip replacement (adjusted OR = 0.89, 95 % CI 0.65-1.22) or knee replacement (adjusted OR = 0.74, 95 % CI 0.49-1.11) as compared to long-term coxib use. Results were not different after stratification by gender, age, and cardiovascular or gastrointestinal disease. This study shows that long-term users of nonselective NSAIDs do not have a different risk of hip or knee replacement as compared to long-term coxib users. Therefore, our results do not support that patients with OA could benefit from using coxibs in order to slow progression of this disease.

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Published date: December 2012
Organisations: Faculty of Health Sciences

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Local EPrints ID: 348269
URI: http://eprints.soton.ac.uk/id/eprint/348269
ISSN: 0171-967X
PURE UUID: 44921707-d381-45ab-91dc-c5ba8941f071

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Date deposited: 11 Feb 2013 11:27
Last modified: 14 Mar 2024 12:56

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Contributors

Author: C. Klop
Author: Frank de Vries
Author: A. Lalmohamed
Author: S.C. Mastbergen
Author: H.G. Leufkens
Author: W.H. Noort-van-der-Laan
Author: J.W. Bijlsma
Author: P.M. Welsing

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