Meloxicam leads to few stomach upsets

Many people with arthritis and other painful conditions take non-steroidal anti-inflammatory drugs (NSAIDs) every day, which can cause stomach problems such as ulcers. One of these drugs, meloxicam, seems to have an edge in this regard, according to a new study.

"Our study showed that meloxicam 7.5 milligrams per day had a better gastrointestinal safety profile than diclofenac, piroxicam and naproxen," lead investigator Dr. Gurkipal Singh told Reuters Health. "At a 15-milligram per day dose, it was statistically better than piroxicam."

Meloxicam is sold under the brand name Mobic by Boehringer-Ingelheim Pharmaceuticals Inc., which sponsored the study. Diclofenac, piroxicam and naproxen are known by various names, including Arthrotec and Voltaren (diclofenac); Feldene (piroxicam); and Anaprox or Naprosyn (naproxen).

As described in the American Journal of Medicine, Dr. Singh of Stanford University School of Medicine, California, and colleagues reviewed 28 NSAID studies involving 24,196 patients. Most participants were followed for up to 60 days.

In total 10,158 patients were given daily meloxicam at a dose of 7.5 milligrams (mg), 2960 received 15 mg; 5283 were given diclofenac at 100 mg, 181 received 150 mg; 5371 got piroxicam at 20 mg; and 243 received naproxen, 500 mg twice daily.

Patients given meloxicam 7.5 mg had a 0.03 percent risk of serious upper gastrointestinal side effects. This was significantly lower than the risk with any of the other NSAIDS. However, at 15-mg per day, meloxicam was only significantly safer than piroxicam.

While meloxicam seems better than the others, the researchers point out that "only a small number of patients were followed for more than 60 days."

SOURCE: American Journal of Medicine, July 15, 2004.

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