Etoricoxib: equipped with MEDAL-winning safety data?

Abstract

According to data from the MEDAL program, results of which were presented at both the joint 70th Annual Scientific Meeting of the American College of Rheumatology and the 41st Annual Meeting of the Association of Rheumatology Health Professional (ACR/ARHP) [Washington, District of Columbia, US; November 2006], and the 79th Scientific Sessions of the American Heart Association (AHA) [Chicago, Illinois, US; November 2006], the COX-2 selective NSAID etoricoxib [Arcoxia] has a similar cardiovascular safety profile to the traditional non-selective NSAID, and most commonly used NSAID worldwide, diclofenac. The Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) program pooled data from three randomised, double-blind, multinational trials conducted in more than 34,000 patients with rheumatoid arthritis or osteoarthritis. Etoricoxib and diclofenac were associated with a similar cumulative incidence of thrombotic cardiovascular events (the primary endpoint of the program). However, the COX-2 selective inhibitor had no significant benefit over the traditional NSAID with respect to complicated GI events, despite improved GI tolerability being the reason behind the development of the COX-2 drug class.