comparative assessment of cardiovascular safety profile between traditional nsaids and cox-2 inhibitors in osteoarthritis

Objective: osteoarthritis (oa) is arthritis and one of the main reasons of disability in the elderly whose treatment focuses on reducing pain and improving performance. this research aims to assess systematically the cardiovascular risks associated with various non-steroidal anti-inflammatory drugs (nsaids) and some selective cox-2 inhibitors. this study compared cardiovascular risk ratios (rr), hazard ratios (hr), and odds ratios (or) across different drugs.  material and methods: the required data are gathered by two independent reviewers using a standardized data extraction form. the extracted data included study characteristics (author, year of publication, study design, sample size, duration of follow-up), patient demographics, types of nsaids and cox-2 inhibitors used, and reported cardiovascular outcomes. results: the findings revealed substantial variation in cardiovascular risk among the drugs studied. etoricoxib exhibited the highest cardiovascular risk, with a relative risk (rr) of 2.05, indicating the risk of cardiovascular events with regard to the control group. rofecoxib also posed a significant risk (rr of 1.45), followed by etodolac (rr of 1.55) and diclofenac (rr of 1.40). among the nsaids, ibuprofen and naproxen were associated with lower cardiovascular risks, with naproxen demonstrating the lowest risk (rr of 1.09). subgroup analysis indicated that selective cox-2 inhibitors generally carried higher cardiovascular risks compared to non-selective nsaids, with mean effect sizes of 1.38 and 1.29, respectively. the study concludes that cardiovascular risks should be a key consideration when prescribing nsaids and cox-2 inhibitors.conclusion: the findings suggest that etoricoxib and rofecoxib present the highest cardiovascular risks, indicating that their use should be restricted to patients without preexisting cardiovascular conditions when the therapeutic benefits clearly outweigh the risks. in contrast, ibuprofen and naproxen appear to be containing lower cardiovascular risks, making them potentially safer choices for long-term use, especially in patients suffered from cardiovascular.