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In Reply: Dr Finucane points out that the safety profiles of celecoxib and standard NSAIDs are roughly comparable at 12 months. It is unclear why gastric ulcerative changes would differ at 6 or 12 months or whether the same can be said for rofcoxib, another COX-2 inhibitor.¹ Nonetheless, physicians should consider the drugs' equivalent therapeutic benefits and cost differentials when chosing a specific NSAID for individual patients.

In response to Dr Egener, while appropriately dosed and supervised administration of opioid medication may have a role in the treatment of severe debilitating pain from osteoarthritis, I do not believe that the long-term use of opioid medications is necessary or safe in the vast majority of patients with osteoarthritis.

While some persons with osteoarthritis are not candidates for surgical treatment because of medical comorbidities, and others simply choose not to have surgery, I have rarely found the pain of osteoarthritis to be . . . [Full Text of this Article]

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