Document Detail


What therapies have replaced rofecoxib in Ireland?
MedLine Citation:
PMID:  17555468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To examine prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics in patients prescribed chronic rofecoxib treatment prior to withdrawal from the Irish market, and to determine the impact on proton pump inhibitor (PPI) co-prescription.
METHODS: Using a national prescribing database, adults (> or =16 years) prescribed rofecoxib for > or =3 months, but not analgesics, from January to September 2004 were identified. A longitudinal prescribing history was used to determine switching patterns to other cyclooxygenase (COX)-2 inhibitors, NSAIDs or analgesics during 3 and 12 months after withdrawal. Concomitant PPI prescription was examined. Logistic regression was used to determine the likelihood of switching to a COX-2 inhibitor vs. nonselective NSAID and factors influencing concomitant PPI prescription.
RESULTS: After rofecoxib withdrawal, 30.2% (1558) and 17.9% (922) of the 5155 study subjects received no further NSAID prescription during 3 and 12 months, respectively. During the 12-month period, approximately one-third of NSAID prescriptions were for <3 months; 40.7% (2096) received sequential prescriptions for different NSAIDs. Co-prescription of analgesics occurred in 49.3% (2539) of subjects. Neither age nor gender influenced the type of NSAID prescribed in the 12 months post rofecoxib withdrawal. PPI prescription increased by 5.5% during the study, associated with use of nonselective NSAIDs, prior use of PPIs and increasing age.
CONCLUSIONS: The majority of those receiving chronic rofecoxib therapy were prescribed either no further NSAID or short-term NSAID therapy only during the 12 months post withdrawal, which suggests the subsequent controversy may have encouraged prescribers to adhere more closely to published guidelines.
Authors:
Mary Teeling; Humphrey O'Connor; John Feely; Kathleen Bennett
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Publication Detail:
Type:  Journal Article     Date:  2007-06-06
Journal Detail:
Title:  British journal of clinical pharmacology     Volume:  64     ISSN:  0306-5251     ISO Abbreviation:  Br J Clin Pharmacol     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-20     Completed Date:  2008-03-14     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  7503323     Medline TA:  Br J Clin Pharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  536-41     Citation Subset:  IM    
Affiliation:
Department of Pharmacology and Therapeutics, Trinity College/St James's Hospital, Dublin, Ireland. teelingm@tcd.ie
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage,  adverse effects*
Cohort Studies
Cyclooxygenase 2 Inhibitors / administration & dosage,  adverse effects*
Drug Prescriptions
Drug Utilization / trends*
Female
Humans
Ireland
Lactones / administration & dosage,  adverse effects*
Male
Middle Aged
Proton Pump Inhibitors / therapeutic use*
Sulfones / administration & dosage,  adverse effects*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase 2 Inhibitors; 0/Lactones; 0/Proton Pump Inhibitors; 0/Sulfones; 0/rofecoxib
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