The risk of gastrointestinal bleed, myocardial infarction, and newly diagnosed hypertension in users of meloxicam, diclofenac, naproxen, and piroxicam.
OBJECTIVE
To obtain formally quantified data on the relation of meloxicam to newly diagnosed gastrointestinal problems, myocardial infarction, or treated hypertension.


METHODS
Nested case-control study.


METHODS
United Kingdom-based General Practice Research Database.


METHODS
Patients who received prescriptions for meloxicam, diclofenac, naproxen, or piroxicam formed the study population. Cases were people who developed gastrointestinal problems, myocardial infarction, or hypertension.


RESULTS
Relative risk estimates for developing the study outcomes were provided for each study nonsteroidal antiinflammatory drug (NSAID), with diclofenac as the reference drug. In no instance was meloxicam associated with an increased risk for a study outcome.


CONCLUSIONS
Compared with the other NSAIDs, meloxicam was not materially associated with any study outcomes. This study provides reassurance to those prescribing this newer class of NSAIDs.
Jick
S S
SS
Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts, USA. sjick@bu.edu
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016022:Case-Control Studies; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D016208:Databases, Factual; D004008:Diclofenac / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology*; D007527:Isoenzymes / Q000378:metabolism; D000077239:Meloxicam; D008565:Membrane Proteins; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000453:epidemiology*; D009288:Naproxen / Q000009:adverse effects; D010894:Piroxicam / Q000009:adverse effects; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D018570:Risk Assessment; D013843:Thiazines / Q000009:adverse effects*; D013844:Thiazoles / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D013843:Thiazines; D013844:Thiazoles; D010894:Piroxicam; D004008:Diclofenac; D009288:Naproxen; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000077239:Meloxicam