While Cox-2 selective anti-inflammatory medicines may be useful for some patients, the available evidence indicates that patients treated with selective Cox-2 inhibitors may be at a slightly increased risk of cardiovascular problems such as heart attacks and strokes. Rofecoxib (Vioxx, Vioxxacute) was withdrawn in September 2004 because evidence of increased risk after long-term treatment. It is not possible to measure the increased risk precisely from the available evidence, but Cox-2 inhibitors may be associated with about 3 additional thrombotic events per 1000 patients per year in the general population (see British Medical Journal http://bmj.bmjjournals.com/cgi/content/full/332/7553/1302). Information about the European review of the safety of coxibs can be found on the European Medicines Agency (EMA) website.