Researchers in the randomized Multinational Etoricoxib and Diclofenac Arthritis Long-term (MEDAL) study program found identical rates of thrombotic cardiovascular events in patients with osteoarthritis or rheumatoid arthritis treated with either the COX-2 inhibitor or the traditional NSAID. Christopher Cannon, M.D., an associate professor of medicine at Harvard Medical School, Boston, noted that this appears to contradict earlier observational studies associating COX-2 inhibitors with higher rates of thrombotic cardiovascular events.
However, the AHA has advised that the study should be interpreted with caution. There was no placebo group in this trial, and there was no comparison with a group of patients given other, less-selective NSAIDs in combination with a proton pump inhibitor.