Sirs, Meloxicam is a selective COX-2 inhibitor with a COX-2/COX-1 ratio of 10 in the whole blood assay (2). With once daily dosage, meloxicam has demonstrated efficacy in osteoarthritis and rheumatoid arthritis (3). Meloxicam in daily doses of 7.5 mg to 15 mg has been reported to be as effe ct ive as traditional nonsteroidal antiinflammatory drugs (NSAIDs) such as dicl o fenac or pirox icam, but with a more favo u rable ga st rointestinal adve rse eve nt profile (4).

Although nearly all children with juvenile rheumatoid arthritis (JRA) receive NSAID at some point of their disease course, up to 50% of them report gastrointestinal complaints during therapy with classical NSAIDs (5). The mechanism by which these events occur may include the inhibition of the synthesis of constitutive prostaglandins via the C OX-1 pat h way. During the phase I/II study of meloxicam for children with JRA, a good drug effectiveness and tolerability was observed (1). Encouraged by these results a therapeutic observation was started on January 1, 1999, using the same MX dosage (0.25 mg/kg once a day). The data was evaluated in the form of a retrospective chart review.