At the 20th ILAR Congress (International League of Associations for Rheumatology) titled "Rheumatology for the 21st Century", data from the MELISSA and SELECT clinical trials were presented showing this evidence compared to two other commonly prescribed nonsteroid anti-inflammatory drugs (NSAIDs). This benefit is demonstrated even for patients receiving co-prescription of acetylsalicylic acid (ASA) used for cardiovascular prophylaxis. Such co-prescription is considered a risk factor for experiencing gastrointestinal adverse events during NSAID therapy.

Gastrointestinal intolerance has been reported in up to 50% of patients on long-term NSAIDs. In light of the medical community's concern about the gastrointestinal and cardiovascular side effects of NSAIDs and selective COX-2 inhibitors, the safety findings from the two large-scale clinical studies MELISSA and SELECT are especially noteworthy.

The data presented offer reassurance to meloxicam's overall safety profile regarding the gastrointestinal tract not only for the osteoarthritic patient in general but now also regarding those patients requiring concomitant low dose aspirin for cardiovascular prophylaxis.

Data from 17,979 osteoarthritic patients were analysed with respect to the effect of ASA co-prescription on the reported incidence of gastrointestinal adverse events. Patients were on NSAID therapy with either meloxicam 7.5 mg or two non-COX-2 selective NSAIDs and have been monitored over four weeks.

The results of this evaluation is complementary to a cardiovascular study previously presented by Dr Gurkipal Singh from Stanford University Medical Center in the USA. "Meloxicam's superior GI tolerability compared with traditional NSAIDs such as diclofenac and its overall safety profile is well documented. The new data on the overall safety profile is good as they are suggesting that the findings highlighted with some COX-2 selective inhibitors is not a class effect".

The favourable gastrointestinal tolerability in patients receiving concomitant ASA add to the results of the overall safety profile evaluation of meloxicam. Recently, the governmental organisation NICE (National Institute for Clinical Excellence, which advises the NHS on medical treatments in the United Kingdom) recommended meloxicam (Mobic(r)/Mobec(r)/ Mobicox(r)) among three other COX-2-selective inhibitors, etodolac, celecoxib and rofecoxib for the management of patients with Osteoarthritis and Rheumatoid Arthritis1.

While all NSAIDs can cause some gastrointestinal symptoms varying from inconvenient to fatal, many side effects can be reduced with the use of selective COX-2 inhibitors. The COX-2s show equivalent effectiveness in alleviating pain and stiffness as their less well-tolerated NSAID predecessors. The new results come along with this recently issued guidance recognising the importance of clinicians having access to modern anti-inflammatory agents which combine a high level of efficacy with an enhanced tolerability profile.

MOBIC(r) (meloxicam)

MOBIC(r) is a selective COX-2 inhibitor developed by Boehringer Ingelheim which is indicated for the symptomatic treatment of painful osteoarthritis, rheumatoid arthritis and ankylosing spondylitis (indications may vary from country to country). MOBIC(r) has been used by more than 45 million patients in 100 countries worldwide. MOBIC(r), classified pharmacologically as a selective COX-2 inhibitor, offers a balance between reliable efficacy and overall safety, including a favorable gastrointestinal (GI) tolerability profile.