PJ Online | POEM | Meloxicam as safe as some other NSAIDs

Home > PJ (current issue) > POEM

PJ Online homeThe Salvadore
Vol 274 No 7338 p228
26 February 2005

This article
Reprint   Photocopy

PDF 35K, Acrobat Reader

POEM (Patient-Oriented Evidence that Matters)

Meloxicam as safe as some other NSAIDs

POEM series


Clinical question Is meloxicam (Mobic) as safe as other non-steroidal anti-inflammatory drugs?

Bottom line Short-term use of meloxicam at a daily dose of 7.5mg is less likely than piroxicam, diclofenac or naproxen to be associated with serious gastrointestinal complications. However, the absolute risk differences are less than 1 per cent. Meloxicam has not been shown to be associated with heart attacks and strokes. A direct comparison with ibuprofen is needed.

Synopsis Meloxicam (Mobic) is a non-steroidal anti-inflammatory drug (NSAID) that preferentially inhibits the cyclo-oxygenase-2 (COX-2) receptor. These authors pooled data from 28 published and unpublished trials including a total of 24,196 patients to assess meloxicam’s safety profile. Most trials were for 60 days or less and compared meloxicam 7.5mg or 15mg per day (n=13,118) with diclofenac 100–150mg per day (n=5,464), piroxicam 20mg per day (n=5,371) or naproxen 500mg twice daily (n=243). Serious gastrointestinal complications included gastric or duodenal perforation, gastric outlet obstruction, and haemodynamically important gastrointestinal bleeding. Thromboembolic events included myocardial infarction and stroke, but not deep venous thrombosis or pulmonary embolism. The investigators who judged whether adverse events met the definitions used in this study were blinded to treatment allocation. There were 54 serious gastrointestinal events that occurred in less than 1 per cent of any treatment group. So, all numbers needed to harm (NNTH) will be higher than 100. Significantly fewer gastrointestinal events were seen with the 7.5mg dose of meloxicam compared with each of the other NSAIDs. At the 15mg dose, the risk with meloxicam was significantly less only than with piroxicam. Thromboembolic events were less frequent with either dose of meloxicam than with diclofenac (NNTH=720, 95 per cent confidence interval 320–5,717). There were no differences in risk for cardiovascular events seen with meloxicam compared with piroxicam or naproxen, with trends favouring meloxicam.

Level of evidence = 1a (systematic review of RCTs, with homogeneity)

Reference Singh G, Lanes S, Triadafilopoulos G. Risk of serious upper gastrointestinal and cardiovascular thromboembolic complications with meloxicam. American Journal of Medicine


POEM (Patient Oriented Evidence that Matters) is a registered trademark of InfoPOEMs
© 1995–2004

Back to Top

©The Salvadore

Citation: The Salvadore URI: 20014116

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Handbook of Pharmaceutical Excipients

    The Handbook of Pharmaceutical Excipients contains essential data on the physical properties of excipients, their safe use and potential toxicity.

    £415.00
  • Injectable Drugs Guide

    A user friendly, single point of reference for healthcare professionals in the safe and effective administration of injectable medicines.

    £54.00
  • Popular Medicines

    An illustrated history of some of the most popular branded medicines. Includes colourful historical adverts and details of the medicine's formula and intended purpose.

    £22.00

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.

https://steroid-pharm.com

steroid-pharm.com

www.adulttorrent.org