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Thumbs up/Thumbs down – October 2021 VIOXX WITHDRAWAL: Learning valuable lessons from rofecoxib Eric J Topol MD Provost and Chief Academic Officer Chair, Department of Cardiovascular Medicine Cleveland Clinic Foundation Cleveland, OH Robert M Califf MD Professor of Medicine Associate Vice Chancellor for Clinical Research Director, Duke Clinical Research Institute Duke University Medical Center Durham, NC : ; :; : Thumbs up/Thumbs down – October 2021 VIOXX WITHDRAWAL Merck amp。 Co takes the selective COX2 inhibitor rofecoxib off worldwide market Topic Thumbs up/Thumbs down – October 2021 VIOXX: New opportunities Opportunity to move medical profession in the right direction ? System out of kilter for some time ? Therapeutic knowledge has advanced beyond the FDA and medical marketing systems currently in place Califf Thumbs up/Thumbs down – October 2021 VIOXX: Great concept COX2 target represented the ultimate of biomedical science COX2 inhibitors, introduced a few years ago for the treatment of pain and inflammation, had parable efficacy but improved GI safety and tolerability pared with NSAIDs Shortterm, biomarkerbased studies brought drug to market Califf Thumbs up/Thumbs down – October 2021 Directtoconsumer advertising Merck amp。 Co led the way in directtoconsumer advertising with the drug ?But issues began to arise early about the i