NICE issues stringent COX-2 guidance

The U.K.'s National Institute for Clinical Excellence (NICE) issued guidance for COX-2 inhibitors, stating that such products are not recommended for routine use in patients with rheumatoid arthritis or osteoarthritis. Instead, NICE said COX-2 inhibitors should replace NSAIDs only in RA and OA patients at high risk of developing serious gastrointestinal problems, including patients >65 years old, those taking medications with known GI side effects and patients with existing GI problems. The guidance affects four marketed COX-2 inhibitors in the U.K.: Vioxx rofecoxib from Merck (MRK), Celebrex celecoxib from Pharmacia (PHA), Lodine etodolac from Shire (LSE:SHP; SHPGY), and Mobic meloxicam from Boehringer Ingelheim (Ingelheim, Germany). ...