TY - JOUR T1 - Evidence in practice — number 3: <strong>Cox 2 inhibitors</strong> JF - British Journal of General Practice JO - Br J Gen Pract SP - 880 LP - 881 VL - 54 IS - 508 AU - Nick Summerton Y1 - 2004/11/01 UR - http://bjgp.org/content/54/508/880.abstract N2 - The evidence. Schnitzer TJ, Burmester GR, Mysler E, et al. Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastro-intestinal Event Trial (TARGET), reduction in ulcer complications: randomised controlled trial. Lancet 2004; 364(9435): 665–674.1Farkouh ME, Kirshner H, Harrington RA, et al. Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial. Lancet 2004; 364(9435): 675–684.2Background. In 2001 the National Institute of Clinical Excellence produced guidance on the use of the first generation Cox-2 inhibitors (celecoxib, rofecoxib, meloxicam, and etodolac) and suggested that these drugs could have a role in patients requiring a non-steroidal anti-inflammatory drug (NSAID) who may be at ‘high risk’ of developing gastrointestinal adverse effects. However, some concerns were expressed about the prescription of Cox-2s in patients with cardiovascular disease, particularly those on low dose aspirin. In the VIGOR trial refecoxib was associated with an increase in myocardial infarctions compared with naproxen.3Study design and intervention. TARGET was a double-blind, double-dummy parallel group randomised, controlled trial. In such a design, each group of participants receives one of the active interventions and a placebo (in this case called a dummy) … ER -