Rofecoxib for the treatment of pain

Rofecoxib, like Celecoxib, is a COX-2 specific inhibitor. Both agents are approved for the treatment of osteoarthritis, whereas Rofecoxib also has approval for management of acute pain. Both drugs demonstrate a reduced incidence of endoscopic ulcers. One can anticipate that these drugs can be used with reduced incidence of serious GI events. Whether or not patients with previous ulcer complications, the highest risk patients gastroenterologists are asked to treat, can use these drugs without co-therapy remains uncertain. This patient subgroup has not been studied in these clinical trials. There is also limited safety information for patients with significant hepatic disease. Despite their cost, the use of safer nonsteroidal antiinflammatory drugs can be highly cost effective, particularly in high-risk patients because of the reduction in subsequent overall disease management costs [11]. While long-term studies demonstrating the proven reductions in serious GI complication rates are ongoing, one can anticipate that these agents appear to have disassociated the GI risks of antiinflammatory therapy from their benefits in the management of arthritis and pain.