Interventions for the prevention or treatment of disease thatare based on our understanding of the pathobiologic featuresof the illness can provide benefit in how a patient feels orfunctions or in whether the patient survives. Such benefitsare generally achieved through on-target biologic effects ofthe intervention. However, there are numerous recent cases inwhich it has been established or strongly suggested that off-targeteffects of such interventions have adversely altered their risk–benefitprofile. For example, in patients with rheumatoid arthritisor osteoarthritis, the cyclooxygenase-2 (COX-2) inhibitors providean analgesic benefit with a reduced risk of gastrointestinalside . . . [Full Text of this Article]
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From the Department of Biostatistics, University of Washington, Seattle.
This article (10.1056/NEJMe0807372) was published at www.nejm.org on September 3, 2008.
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