Study links Pfizer's painkiller Celebrex to an increased risk of myocardial infarction

A new meta-analysis by Brent Caldwell et al, published in the Journal of the Royal Society of Medicine (volume 99 March 2006), concludes that there is a higher risk of myocardial infarction in patients taking drug giant Pfizer's popular painkiller Celebrex (celecoxib), compared with placebo or traditional non-steroidal anti-inflammatory drugs. The authors say that their analysis of six selected studies also indicates an increased risk of heart attack across all COX-2 inhibitors.

Data selection criteria

The group's analysis examined data which had already been submitted to European regulatory authorities, specifically to the European Medicines Agency (EMEA) and the then Committee on Safety of Medicines. Initially, the researchers queried a range of information resources (Medline, the Cochrane Database of Systematic Reviews and Central Register of Controlled trials, the ACP Journal Club, the database of Abstracts of review of Effects and Embase to April 2005) for the key phrases "celecoxib" and "COX-2 inhibitors and cardiovascular events". In addition, data from the US Food and Drug Administration and from several web sites reviewing the drug were included. The collated information was then independently examined by two researchers according to strict inclusion criteria. Studies had to be randomized, placebo-controlled and at least six weeks in duration, as well as including information about any cardiovascular thromboembolic events that occurred.