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" ... Merck’s Vioxx, a member of a class of anti-inflammatory drugs called COX-2 inhibitors, was flying high when it was launched in 1999. It boasted remarkable arthritis pain relief, yet didn’t cause the gastrointestinal distress that accompanied other non-steroidal anti-inflammatory drugs like ibuprofen and naproxen. These attractive properties drove Vioxx to billion dollar annual sales. ... "
" ... Migraine is a disease with significant unmet medical need. Notably, the World Health Organization selected migraine as a condition which should be prioritized for development of more effective treatments. While several classes of migraine treatments are available for many patients - both over-the-counter and by prescription – their effectiveness is limited. Some treatments address pain associated with migraine. These include acetaminophen, caffeine, non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen and naproxen, as well as beta-blockers and anti-depressants. Others are migraine-specific therapies, such as triptans (selective 5-hydroxytryptamine serotonin receptor agonists). Although triptans provide relief to some patients for moderate to severe migraine attacks, they do not prevent recurrences. ... "
" ... Of the over-the-counter analgesics, only aspirin and NSAIDs like ibuprofen or naproxen have anti-inflammatory activity. Acetaminophen is primarily a weak analgesic. But if you can't tolerate aspirin or the NSAIDs, acetaminophen is the only over-the-counter alternative. ... "
" ... The results of PRECISION were noteworthy. There were 188 deaths (2.3%) from cardiovascular causes for the Celebrex patients, 201 deaths (2.5%) for those on naproxen, and 218 (2.7%) for ibuprofen patients, leading the NEJM authors to say that “the PRECISION trial provides statistically strong evidence that cardiovascular risk associated with moderate doses of celecoxib is not greater that that associated with non-selective NSAIDs”. The PRECISION study also provided other revelations. While the primary purpose of the trial was to assess cardiovascular outcomes, GI and renal outcomes were secondary endpoints. Celebrex had significantly fewer GI safety issues – the basis for the development of this drug. Furthermore, the rates of renal adverse events and hospitalizations for high blood pressure were also significantly lower for Celebrex compared to ibuprofen. ... "