{"id":43,"date":"2006-11-20T12:56:30","date_gmt":"2006-11-20T11:56:30","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2006\/11\/20\/lancet-18-nov-2006\/"},"modified":"2006-11-20T12:56:30","modified_gmt":"2006-11-20T11:56:30","slug":"lancet-18-nov-2006","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2006\/11\/20\/lancet-18-nov-2006\/","title":{"rendered":"Lancet 18 Nov 2006"},"content":{"rendered":"<p>Two years ago, we were all rather shocked when the COX-2 specific drug rofecoxib was accused of increasing <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606696669\/fulltext\">cardiovascular risk<\/a>. There has been a flurry of reviews and meta-analyses since then, to which this <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606696669\/fulltext\">study <\/a>(MEDAL) comes as an afterword, confirming what we already know. <!--more-->It finds that <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606696669\/fulltext\">etoricoxib <\/a>and <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606696669\/fulltext\">diclofenac <\/a>at usual dosage carry about the same added risk (about 30%) of stroke, myocardial infarction and peripheral artery occlusion, but GI bleeds are less common with etoricoxib. The accompanying <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606696670\/fulltext\">editorial<\/a> is a reasonable summary of our knowledge to date, and reading it I wonder if most of our long term NSAID-taking patients wouldn\u2019t be better off taking naproxen, which is cheap, effective and carries no cardiovascular risk, though many might also need to take a proton pump inhibitor.<\/p>\n<p>An intelligent young patient of mine has just been given a diagnosis of <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606697407\/fulltext\">retinitis pigmentosa<\/a>, specifically due to Usher\u2019s syndrome type II. Naturally, having looked them up on Google, she now knows a lot more about these conditions than I do. But if I want to try and get ahead of her, <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606697407\/fulltext\">this <\/a>is the place to look: a fantastically thorough <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140673606697407\/fulltext\">summary <\/a>of current knowledge (264 references), ending with a lengthy section on possible future treatments.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Two years ago, we were all rather shocked when the COX-2 specific drug rofecoxib was accused of increasing cardiovascular risk. There has been a flurry of reviews and meta-analyses since then, to which this study (MEDAL) comes as an afterword, confirming what we already know. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmj\/2006\/11\/20\/lancet-18-nov-2006\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[111],"tags":[],"class_list":["post-43","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"jetpack_featured_media_url":"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2017\/02\/richard-lehman.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/43","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=43"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/43\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media\/38363"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=43"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=43"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=43"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}