Coxib and traditional NSAID Trialists’ (CNT) Collaboration
A collaborative meta-analysis of individual participant data from all randomised trials with at least one unconfounded comparison involving a selective cyclo-oxygenase-2 inhibitor (coxib) or a traditional non-steroidal anti-inflammatory drug (tNSAID).
Traditional non-steroidal anti-inflammatory drugs (tNSAIDs) and newer selective cyclooxygenase-2 inhibitors (coxibs) are widely used for analgesia, but they have potentially serious vascular and gastrointestinal risks. A meta-analysis of tabular data from randomised trials of at least 4 weeks’ duration involving a coxib versus placebo, or a coxib versus a traditional NSAID, has provided some limited information about the risk of vascular events associated with these drugs. Although this has been used by regulatory authorities in informing treatment choices for the public, a meta-analysis of individual participant data from these trials would be substantially more informative. The pharmaceutical sponsors of coxib trials and their investigators have agreed to provide data to form a collaboration (the Coxib and traditional NSAID Trialists’ [CNT] Collaboration), in order to assemble and maintain a database of individual participant data from all unconfounded trials, published and unpublished, of at least four weeks duration which have involved a coxib or tNSAID. The chief aim of this Collaboration will be to conduct analyses of the effects of coxibs and tNSAIDs on the most common adverse effects of coxibs and tNSAIDs, namely “serious vascular events” and “symptomatic ulcer or upper gastrointestinal (GI) complications”. We aim to update the results of this meta-analysis when the results of new trials become available.
