Risk of hospitalization for angio-oedema among users of newer COX-2 selective inhibitors and other nonsteroidal anti-inflammatory drugs.
OBJECTIVE
To 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.


METHODS
Cases 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 Registration 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.


RESULTS
The 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).


CONCLUSIONS
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.
Downing
Amy
A
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. a.downing@leeds.ac.uk
Jacobsen
Jacob
J
Sorensen
Henrik T
HT
McLaughlin
Joseph K
JK
Johnsen
Soren P
SP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000799:Angioedema / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors