【正文】 What happens next? Practical applications ? For patients with chronic joint pain that meets the criteria for NSAIDs, the best bet would be naproxen, based on the TARGET data ? It is also remended that a generic protonpump inhibitor be prescribed for patients at significant risk of GI bleeding 。s thoughts In the VIOXX Gastrointestinal Outes Research (VIGOR) studywhich indicated an increased risk of cardiovascular events with rofecoxib vs naproxencurves diverged at 30 days You can get an MI or stroke from one Vioxx pill. Topol Thumbs up/Thumbs down – October 2021 VIOXX: Should have acted earlier There was the potential for Merck and the FDA to do the right thing much earlier ? Merck defended past studies as flawed and the drug as cardioprotective ? Directtoconsumer advertising fueled the induction of MI and stroke ? Drug launch most successful in history of pharmaceuticals Topol Thumbs up/Thumbs down – October 2021 VIOXX: Equal playing fields Other drugs have been flagged for cardiovascular toxicity and not all of these have oute studies Califf Then I would say, Uhoh, we got a problem. What39。 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 advance